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What is the cause for itchy, swollen and painful toe?

Jan 2014
User rating for this question
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Answered by

Practicing since : 2002
Answered : 7233 Questions
My second toe is extremely itchy, swollen (at the very tip under the nail) and painful. This is secondary to running a marathon next week. It's keeping me up at night and getting worse. Perhaps broken? I do not think it is a fungal infection. *I mean "running a marathon LAST week". I am able to still run and walk, but this toe is just super itchy and swollen! More information: After running the marathon, there was a large blood blister underneath the toenail. This burst, but now the area under the nail is tender and throbbing. This toe doesn't bend as well as the others, and I have also (about 1 year ago) noticed an increased vein network leading to this toe
Posted Mon, 6 Jan 2014 in Skin Hair and Nails
Answered by Dr. Kakkar S. 22 minutes later
Brief Answer: Paronychia is a possibility, Need Close-Up pic Detailed Answer: Hi. Thanks for posting your concern at XXXXXXX After going through your query and having a look at the picture, i would like to keep a possibility of 'Paronychia' of the affected toe. I would like to gather some more information from you in order to help you better. Is their oozing/discharge? I would be greatly helped if you could send me a close up photograph of the affected toe, with good clarity. take care regards
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Follow-up: What is the cause for itchy, swollen and painful toe? 10 minutes later
No oozing or discharge. The skin is "tight" though and definitely swollen. The nail on this toe also grows flatter than on the others. I don't have a high-definition camera--just what is on my computer. Hope these pictures help.
Answered by Dr. Kakkar S. 16 minutes later
Brief Answer: Paronychia + possible Onychomycosis Detailed Answer: Hi. thanks for the pictures. Swollen, red and painful/tender toe...its definitely Acute Paronychia. If i were your treating doctor i would have put you on a week of oral antibiotics (Penicillin group Or cephalosporin group). Oral Anti-inflammatory/ Analgesic like ibuprofen twice or thrice daily will help you with the pain part I could also see that some part of the second toe nail has a yellowish discoloration too (on the side which is near to great toe). It seems to be Fungal infection of the second toe nail(Onychomycosis). I would advice that you visit a dermatologist and get a lab test for fungus for confirmation (Nail clipping for KOH examination, Nail culture etc). take care regards
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Follow-up: What is the cause for itchy, swollen and painful toe? 8 minutes later
Thank you very much! If I cannot easily see a dermatologist for at least another week, do you advise any OTC remedies?
Answered by Dr. Kakkar S. 8 minutes later
Brief Answer: Terbinafine 250mg tab for Onychomycosis,once daily Detailed Answer: Hi. For Toe Nail Onychomycosis, I usually ask my patents to take oral Terbinafine 250mg once daily after dinner. For Toe nail Onychomycosis it is recommended to take once daily for 3 months. Since it is a prescription drug, so a dermatologist consultation is required. He/She would be the best person to prescribe you a brand of terbinafine. For Paronychia i usually ask my patients to take either Cefadroxyl OR Cepalexin for a week. Ibuprofen helps to relieve the pain and discomfort associated with it. take care regards
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