Summary
- Usually associated with trauma, either a single event or over a short period due to activity or tight footwear.
- Bruising or discolouration of the subungual and/or periungual tissue
- Care with patients on anticoagulants
Diagnostic tips
- Recent history
- Exclude subungual exostosis, onycholysis, subungual melanocytic lesion
- Acutely painful on pressure
Tests and Imaging
- Xray to exclude fracture or exostosis
Immediate Treatment
- Pierce nail to release pressure
- Review anticoagulant therapy
- Analgesia and appropriate dressing
Possible Referral
- Podiatry for expert debridement and advice on footwear and hosiery
- Podiatry for management of resulting onycholysis
