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What Is The Cause For Itchy, Swollen And Painful Toe?

Posted on Mon, 6 Jan 2014

Question: My second toe is extremely itchy, swollen (at the very tip under the nail) and painful. This is secondary to running a marathon next week. It's keeping me up at night and getting worse. Perhaps broken? I do not think it is a fungal infection. *I mean "running a marathon LAST week". I am able to still run and walk, but this toe is just super itchy and swollen! More information: After running the marathon, there was a large blood blister underneath the toenail. This burst, but now the area under the nail is tender and throbbing. This toe doesn't bend as well as the others, and I have also (about 1 year ago) noticed an increased vein network leading to this toe

Answered by Dr. Dr. Kakkar (22 minutes later)

Brief Answer: Paronychia is a possibility, Need Close-Up pic Detailed Answer: Hi. Thanks for posting your concern at XXXXXXX After going through your query and having a look at the picture, i would like to keep a possibility of 'Paronychia' of the affected toe. I would like to gather some more information from you in order to help you better. Is their oozing/discharge? I would be greatly helped if you could send me a close up photograph of the affected toe, with good clarity. take care regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (10 minutes later)

No oozing or discharge. The skin is "tight" though and definitely swollen. The nail on this toe also grows flatter than on the others. I don't have a high-definition camera--just what is on my computer. Hope these pictures help.

Answered by Dr. Dr. Kakkar (16 minutes later)

Brief Answer: Paronychia + possible Onychomycosis Detailed Answer: Hi. thanks for the pictures. Swollen, red and painful/tender toe...its definitely Acute Paronychia. If i were your treating doctor i would have put you on a week of oral antibiotics (Penicillin group Or cephalosporin group). Oral Anti-inflammatory/ Analgesic like ibuprofen twice or thrice daily will help you with the pain part I could also see that some part of the second toe nail has a yellowish discoloration too (on the side which is near to great toe). It seems to be Fungal infection of the second toe nail(Onychomycosis). I would advice that you visit a dermatologist and get a lab test for fungus for confirmation (Nail clipping for KOH examination, Nail culture etc). take care regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (8 minutes later)

Thank you very much! If I cannot easily see a dermatologist for at least another week, do you advise any OTC remedies?

Answered by Dr. Dr. Kakkar (8 minutes later)

Brief Answer: Terbinafine 250mg tab for Onychomycosis,once daily Detailed Answer: Hi. For Toe Nail Onychomycosis, I usually ask my patents to take oral Terbinafine 250mg once daily after dinner. For Toe nail Onychomycosis it is recommended to take once daily for 3 months. Since it is a prescription drug, so a dermatologist consultation is required. He/She would be the best person to prescribe you a brand of terbinafine. For Paronychia i usually ask my patients to take either Cefadroxyl OR Cepalexin for a week. Ibuprofen helps to relieve the pain and discomfort associated with it. take care regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar