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I have a patient with a very strange hallux. There is a very black powdery part to the nail edge (looks like charcoal) on one side which is not dried old blood. Every time he comes I try to remove ir but it keeps coming back.

What could it be caused by? I am puzzled.

Zsuzsanna

 

Hi zsuzanna,

There are a number of causes. A picture and detailed patient history would be beneficial.

My advice would be for you to go through the patients history and see if this points you to a possible cause, for example, does the patient have Cushing's? This can cause an increase in the melanin stimulating hormone.

It is impossible for anyone to tell you what it is, but here are just a few 'could be's'....

Could be bacterial - get a sample analysed.
Could be fungal - get a sample analysed.
Could be melanoma - 100% needs to be ruled out.
Could be trauma
Could be anything!

My point is, if you don't know, then you need to arrange the relevant tests to form a diagnosis. Once you have a diagnosis you can treat accordingly. Cutting it away and hoping it doesn't return isn't the greatest idea IMO.

:)

 

I worked a similar case, and trauma algeracion ungeal with the matris, you must remove the affected part so as not to cause more trauma, phased achieves better results, high intensity laser beam has improved by 40%
Bayonne P J
Colombia