Subungual Hematoma: Insights From a Clinical Case Study

Subungual hematoma (SH) refers to the accumulation of blood under the nail due to traumatic injury. In this article, we report the case of a 61-year-old male with a history of diabetic neuropathy (DN) who presented to our clinic with an SH on the first toe of the left foot, secondary to direct trauma while working. Due to DN, the patient did not experience pain and did not seek medical attention until he observed generalized black pigmentation on the toenail. After the initial evaluation, the hematoma was drained at the primary care clinic by trephination with an 18-gauge needle. Following the procedure, the patient showed complete remission of the pigmentation with no complications. In this article, we highlight the importance of SH, its clinical presentation, diagnostic suspicion, and appropriate treatment to avoid complications.