Subungual Hematoma

  • Danya Reich
  • Corinna Eleni Psomadakis
  • Bobby Buka


A young woman presented to Primary Care clinic with bilateral hematomas under the nails of her great toes. The woman reported wearing high-heeled shoes for an extended period of time on the night prior to her visit, which may have been responsible for the trauma to her nails. Subungual hematomas are a common complaint in general dermatology, and are typically caused by crushing or traumatic injury. Following injury, blood and fluid accumulates under the nail, causing pain from the pressure buildup, and sometimes leading to separation of the nail plate from the nail bed. Pressure may be relieved by trephination, which involves using a paperclip or small needle to puncture the nail plate. The nail bed should return to its normal color as the nail grows out. If the discoloration from the hematoma does not migrate as the nail grows out, subungual melanoma should be ruled out.


Trauma Traumatic injury Nail bed Bruise Hematoma Subungual Trephination 


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Copyright information

© Springer International Publishing Switzerland 2017

Open Access This chapter is distributed under the terms of the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  • Danya Reich
    • 1
  • Corinna Eleni Psomadakis
    • 2
  • Bobby Buka
    • 3
  1. 1.Department of Family MedicineMount Sinai School of Medicine Attending Mount Sinai Doctors/Beth Israel Medical Group-WilliamsburgBrooklynUSA
  2. 2.School of Medicine Imperial College LondonLondonUK
  3. 3.Department of DermatologyMount Sinai School of MedicineNew YorkUSA

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