underneath a toenail or fingernail (black toenail)
Subungual Hematoma
A subungual hematoma is blood trapped under a nail. By the next day, it has the characteristic black or very dark blue appearance. It's the familiar "black nail" after whacking your finger with a hammer, for instance. Getting attention within hours of the accident can reduce pain and swelling; after the blood clots, however, the affected person just needs to wait until the swelling goes down naturally.
The steps involved in performing a timed 5 minute surgical scrub include removal of all jewelry, cleaning hands using anitmicrobial soap, cleaning subungual areas, and scrubbing the arms.
A blackened nail on the second toe could be due to various reasons such as injury, fungal infection, blood clot under the nail (subungual hematoma), or underlying health issues like diabetes or poor blood circulation. It's recommended to consult a doctor for proper diagnosis and treatment.
Air pockets under the fingernails, also known as subungual hematomas, are often caused by trauma to the nail bed. This trauma can be due to repetitive activities like typing or sports activities. It can also be the result of a sudden injury such as slamming your finger in a door or dropping something heavy on it.
The surgical removal (ablation) of the fingernail or toenail is referred to as an Onychectomy or onychotomy. Hopefully the nail will regrow in a normal fashion.When part or all of the nail bed (matrix) is removed, whether through surgery or chemical means, the procedure is called a Matrisectomy or matrixectomy. This permanently prevents the nail from regrowing.
A painless and small subungual hematoma usually requires no treatment. However, the pressure generated by pooled blood under the nail can be extremely painful. To relieve the pain, you may get decompression, also called trephination, which allows the underlying blood to drain, relieving pressure and pain to the area.
Black toenails can be a sign of injury or trauma to the toe, causing blood to accumulate underneath the nail (subungual hematoma). This can also occur due to repetitive stress or ill-fitting shoes. In some cases, it could indicate a fungal infection. It is recommended to consult a healthcare provider for a proper diagnosis and treatment.
Broken toe, commonly called a fracture, can occur when the toe is stubbed, something drops on the toe or prolonged repetitive stress or movement takes place. Symptoms occurring from broken toe include pain, swelling, stiffness and noticeable bruising at the injury site. The toe may look bent or deformed; walking and wearing shoes may be painful.Most broken toes can be treated through self-care:Elevate the foot above the heart as much as possible to relieve swelling, and prop the foot up with some pillows when sleeping. Apply an ice pack by filling a plastic bag with ice or using frozen peas or corn. Keep the ice pack on the toe for 15 to 20 minutes every 1 to 2 hours. Do this for 1 to 2 days. Protect the skin by wrapping the ice pack in a towel. Keep prolonged standing, walking and strenuous exercise to a minimum while the toe heels and use crutches if needed. Seek immediate care at an emergency facility if any of the following symptoms occur: Cold, numb, or tingling toes, blue or gray skin, open wounds, bleeding or drainage near the broken toe.Immediate complications may occur such as a nail injury and open fracture. Nail injury, called subungual hematoma, is a collection of blood beneath the toenail. A large subungual hematoma requires drainage by a doctor who makes a small hole in the toenail. A very large or painful hematoma may require removing the toenail.Although rare, the broken bone may stick out through the skin, referred to as a compound fracture.To prevent infection, the doctor carefully cleans the wound and prescribes antibiotic medication. In rarer cases surgery may be required. Later complications can include arthritis, pain, stiffness or deformity. This may also require surgery.As alternative therapy, the doctor may tape the injured toe to the toe next to it. This is called buddy taping. The doctor may prescribe a special shoe to wear if the foot or toes are extremely swollen. If the toe is dislocated or rotated, pointing in the wrong directions, the doctor may need to put it back in place using general anesthetic. Recovery from broken toes usually takes six weeks.
It seems that most answers for this include Vitamin B12 deficiencies. B12 is not always available even if taken as a pill because the stomach doesn;t have "intrinsic factor" an enzyme that makes B!@ available . B12 is stored in the liver and the easy way to get is is by a self administered monthly injection, just into a muscle. Other views on flattened nails seem to thin k it might be blood circulatory problem, see Raynaud's disease. Iron and zinc are mentioned too as being deficient. Overall there seems to be no clear answer, so if the nails have become flattened over the last few months, go get a check and a comprehensive blood panel including vitamin and hormones.
DefinitionWarts are small, usually painless growths on the skin caused by a virus called human papillomavirus (HPV). They are generally harmless. However, warts can be disfiguring and embarrassing, and occasionally they itch or hurt (particularly on the feet).The different types of warts include:Common warts usually appear on the hands, but can appear anywhere.Flat warts are generally found on the face and forehead. They are common in children, less common in teens, and rare in adults.Genital warts(condyloma) are usually found on the genitals, in the pubic area, and in the area between the thighs, but they can also appear inside the vagina and anal canal. (See: Genital warts for more information)Plantar warts are found on the soles of the feet.Subungual and periungual warts appear under and around the fingernails or toenails.Alternative NamesPlane juvenile warts; Periungual warts; Subungual warts; Plantar warts; Verruca; Verrucae planae juveniles; Filiform warts; Verruca vulgarisCauses, incidence, and risk factorsThe typical wart is a raised round or oval growth on the skin with a rough surface. Compared with the surrounding normal skin, warts may appear light, dark, or black (rare). Most adults are familiar with the look of a typical wart and have little trouble recognizing it. Unusual warts with smooth surfaces or flat warts in children may be more difficult for parents to recognize.Common warts tend to cause no discomfort unless they are in areas of repeated friction or pressure. Plantar warts, for example, can become extremely painful. Large numbers of plantar warts on the foot may cause difficulty walking or running.Some warts will disappear without treatment, although it can sometimes take a couple of years. Treated or not, warts that go away often reappear. All warts can spread from one part of your own body to another.Unsightly or painful warts can be treated. Warts around and under your nails are much more difficult to cure than warts in other places.SymptomsAbnormally dark or light skin surrounding the lesionNumerous small, smooth, flat (pinhead sized) lesions on forehead, cheeks, arms, or legsRough growths around or under fingernails or toenailsRough, round, or oval lesions on soles of feet -- flat to slightly raised -- painful to pressureSmall, hard, flat or raised skin lesion or lumpSigns and testsWarts can generally be diagnosed simply by their location and appearance. Your doctor may want to cut into a wart (called a biopsy) to confirm that it is not a corn, callus, skin cancer, or other similar-appearing growth.TreatmentOver-the-counter medications can remove warts. These are applied to the wart every day for several weeks. DO NOT use these medications on your face or genitals. It helps to file the wart down when damp (for example, after a bath or shower) before applying these medications. DO NOT treat warts on your face or genitals yourself. See your health care provider.Pain and pressure from plantar warts can be treated with special cushions that are available at drug stores.Your health care provider may use stronger (prescription) medications, such as podophylin or salicylic acid, for removal of persistent warts. Surgical removal or removal by freezing (cryotherapy), burning (electrocautery), or laser treatment may be needed.Immunotherapy, done by injecting a substance that causes an allergic reaction, may also be considered by your health care provider. A topical medication called imiquimod may also be used.A vaccine called Gardasil prevents infection against the strains of viruses that often cause genital warts and cervical cancer in women.DO NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or any other method.Expectations (prognosis)Warts are generally harmless growths that often go away on their own within 2 years. They can be contagious, but transmission from person to person is uncommon. Warts may be unsightly or cause discomfort, especially on the feet.ComplicationsSpread of wartsReturn of warts that disappearedMinor scar formation if the wart is removedFormation of keloids after removalCalling your health care providerCall for an appointment with your doctor if:There are signs of infection (red streaking, pus, discharge, or fever) or bleeding. Warts can bleed a little, but if bleeding is significant or not easily stopped by light pressure, see a doctor.The wart does not respond to self-care and you want it removed.You have pain associated with the wart.You have anal or genital warts.You have diabetes or a weakened immune system (for example, HIV) and have developed warts.There is any change in the color or appearance of the wart.PreventionAvoid direct skin contact with a wart on someone else.After filing your wart, wash the file carefully since you can spread the virus to other parts of your body.After touching any of your warts, wash your hands carefully.ReferencesWarts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 12.Gibbs S, et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2006;(3):CD001781.