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Subungual Hematoma: Insights From a Clinical Case Study.
Ricardo Cid Puente1, Ana I Diaz de León Guzmán2, Laura S De León Puga3
1Department of Immunology, Biological Sciences School, Universidad Autónoma de Zacatecas, Zacatecas, MEX.
Cureus
|June 23, 2025
Summary
Subungual hematoma (SH) is blood under the nail from injury. This case highlights SH in a diabetic neuropathy patient, emphasizing prompt diagnosis and trephination for successful treatment.
Area of Science:
- Podiatry
- Dermatology
- Diabetology
Background:
- Subungual hematoma (SH) results from subungual bleeding, often due to trauma.
- Diabetic neuropathy (DN) can mask pain, delaying diagnosis of conditions like SH.
- Early recognition and management of SH are crucial to prevent complications.
Observation:
- A 61-year-old male with diabetic neuropathy presented with a subungual hematoma on his left first toe.
- The patient's diabetic neuropathy prevented pain perception, leading to delayed presentation.
- The primary symptom was generalized black pigmentation of the toenail.
Findings:
- Subungual hematoma was diagnosed based on clinical presentation and history of trauma.
- Trephination using an 18-gauge needle effectively drained the hematoma.
- The procedure resulted in complete remission of toenail pigmentation without complications.
Implications:
- This case underscores the importance of considering SH in patients with diabetic neuropathy, even without pain.
- Prompt diagnosis and simple procedures like trephination can lead to excellent outcomes.
- Awareness of SH presentation and management is vital for primary care physicians to avoid potential complications.
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