SUBUNGUAL HEMATOMA

subungual hematoma


A subungual hematoma is a benign collection of blood under the nail. Some patients confuse it with melanoma.

Clinical

A red, blue or purple lesion occurring after trauma is characteristic. The concern for melanoma is sometimes raised. Subungual melanoma originates in the proximal nail fold/matrix and extends linearly outward. The subungual hematoma rarely takes on this morphology. Sometimes a Greek foot (second toe is longer than the great toe) can cause the second toe to overlap the great toe, causing lateral discoloration of the great toe.

Dermoscopy may be helpful, showing red dots and spots. Of note, subungual hemorrhages due to chemotherapy with taxanes develop in up to 80% of patients, leading to infections in 33% and affecting daily activities in 25% of patients [JAAD 2011; 65, Issue 3, Pages 624–635].

Treatment

No treatment is needed. If large and painful, a small hole may be made in the nail plate to allow for drainage.

Additional Pictures

subungual hematoma subungual hematoma

Not much of a "hematoma" here. More like subungual purpura.
subungual hematoma subungual hematoma

Subungual hematoma drained.
subungual hematoma with hole for drainage

subungual hematoma

Biopsy-proven subungual blood.
subungual hematoma

This is a melanoma in situ--not a subungual hematoma. Note the linear extension from the proximal nail fold.
Subungual melanoma in situ

RegionalDerm

Homepage | FAQs | Contact Dr. White


It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.