What can be done for bleeding and pus discharge from toenail?

Hi,

Welcome to icliniq.com.

I have a few questions.

1. How did this start?

2. Did you have trauma to the nail?

3. Is it painful?

4. Is it the only one to nail?

5. How many times it has bled?

6. You mentioned there was pus, was it greenish? Or just frank white pus?

7. Does it smell bad?

8. Are you using any cream or lotion like Betadine or turmeric?

9. When did you take the last dose of the antibiotic pill?

It looks like pyogenic granuloma growing underneath as per the pictures you have attached (the attachments were removed to protect the patient's identity). Also, there is a secondary infection. Pyogenic granuloma is a benign growth of blood capillaries that is usually painless but bleeds with trauma. It can also be a pseudomonas nail infection.

Can you please answer the above questions so that I can make a concrete diagnosis?

Thanks and regards.

Hi,

Welcome back to icliniq.com.

Features are more consistent with pyogenic granuloma with a secondary bacterial infection. Since there is an added infection, it should be treated along with it. Take another course of antibiotics for seven days, tablet Ciprofloxacin 500 mg one tablet twice a day after food for seven days. Best treatment for pyogenic granuloma is removing it off by either cryotherapy, or silver nitrate, or electric cautery, or laser. Please consult your dermatologist and discuss these options.

If you do not want to get any procedure done then you can use Timolol (beta blocker) drops, it takes 2 to 3 weeks to see positive results. For those raw growths, after cleaning it, apply Timolol maleate 0.5 % drops (eye drop) four times a day for 3 to 4 weeks. Please avoid tight shoes and avoid using cotton, use cotton gauze to clean the area, use warm salt water to clean it. Avoid getting hit on the nail, any minor trauma will cause bleeding, if it becomes raw there will more chances of infection.

Hope this helps.

Thanks and regards.

Hi,

Welcome back to icliniq.com.

Clean the toe with warm salt water, do not soak in it. For bleeding, apply pressure with cotton gauze for 5 to 7 minutes, it should stop. If it continues, then put that gauze around the toe and wrap with cotton rollers bandage. Keep the foot elevated when it bleeds. The best treatment would be to get it cauterized so that it does not bleed often.

Hope it helps.

Thanks and regards.

Hi,

Welcome back to icliniq.com.

The best option here is to remove it. If it is not healing after 1 month, then it's good to do a biopsy and know the exact pathology. There are other possibilities apart from pyogenic granulomas, like a myxoid cyst, or glomus tumor. It is not advisable to keep treating it with topical drops when there is not much response to the conservative treatment.

Please visit your nearby dermatologist for a possible biopsy of that growth.

Hope it helps.

Thanks and regards.