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What causes hematoma under a toe nail?

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Posted on Fri, 25 Jul 2014
Question: Hello. I repeatedly suffer from what I thought was pinky toenail trauma. I will get a horizontal, not vertical collection of blood that arises from the cuticle. It always grows off with the nail leaving no discoloration behind. But then, it will happen again and the whole process starts over. I am a nurse and stand on my feet in tennis shoes for 10+hrs per day. Thought maybe I was causing the trauma. Would a subungual melanoma go away and come back or would my cuticle/nail consistently stay discolored?
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Answered by Dr. Johny Chacko (16 minutes later)
Brief Answer:
Trauma related subungual hematoma

Detailed Answer:
Hello,

Welcome to healthcare magic.

I understand from your query that you have bleeding underneath your nail and are worried if it could be a melanoma.

From your history and description, I am of the opinion that the hematoma underneath your nail could be related to mild but constant trauma due to prolonged occlusion from wearing shoes.

Are the shoes tight especially in the front?
The most common cause for subungual hematoma is ill fitting shoes.

As far as your doubt as to whether this could be a subungual melanoma, I do no think so. This is because you have mentioned that it disappears and reappears again, which does not happen with a melanoma. A melanoma would persist irrespective of the nail growth, would spread to the skin and also become more nodular with time.

I would suggest that you try changing the shoes. Wear a shoe with considerable room in the front. ( at least a finger breadth wide).

Hope this helps you.

If you have any more queries, I would be glad to answer.

Regards,
Dr. Johny Chacko

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Johny Chacko (4 minutes later)
Thank you very much. Here is an old pic of a hematoma that has already resolved. I can now see that i am getting a new one now because there is a spot arising from the cuticle. Guess i will try some new shoes. Thanks again
doctor
Answered by Dr. Johny Chacko (1 hour later)
Brief Answer:
Trauma related subungual hematoma

Detailed Answer:
Hello,

Thank you for uploading a clinical picture.

It looks like a resolving subungual hematoma. As I mentioned, you could try using well fitting shoes. Also make sure that you buy shoes which are broad at the front and not narrow.

Hope this helps you.

Wishing you good health,
Dr. Johny Chacko
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Johny Chacko

Dermatologist

Practicing since :2005

Answered : 1916 Questions

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What causes hematoma under a toe nail?

Brief Answer: Trauma related subungual hematoma Detailed Answer: Hello, Welcome to healthcare magic. I understand from your query that you have bleeding underneath your nail and are worried if it could be a melanoma. From your history and description, I am of the opinion that the hematoma underneath your nail could be related to mild but constant trauma due to prolonged occlusion from wearing shoes. Are the shoes tight especially in the front? The most common cause for subungual hematoma is ill fitting shoes. As far as your doubt as to whether this could be a subungual melanoma, I do no think so. This is because you have mentioned that it disappears and reappears again, which does not happen with a melanoma. A melanoma would persist irrespective of the nail growth, would spread to the skin and also become more nodular with time. I would suggest that you try changing the shoes. Wear a shoe with considerable room in the front. ( at least a finger breadth wide). Hope this helps you. If you have any more queries, I would be glad to answer. Regards, Dr. Johny Chacko