Subungual Haematoma

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

 

 

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