Dr. Dhepe Snehal Madhav
Venereology
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Patient's Query
Hello doctor,
I am a 31-year-old female. I just realized I have a black spot on my toenail on the left foot. I wonder what to do. Is it cancer or just blood clot? I do not remember hitting my foot anywhere, and it is not painful. It is a two to three mm black spot. I am currently taking iron and vitamin D supplements.
Hello,
Welcome to icliniq.com.
Do you have any minor trauma? Excess contact with water? Are you a diabetic or any chronic illness? Do you have any drug history? Differential diagnosis are fungal infection (onychomycosis) and subungual melanosis. Use 5 percent Amorolfine nail lacquer four times a week for 12 weeks. Luliconazole lotion twice daily for three months.
Patient's Query
Thank you doctor,
She does not have any trauma. She is not diabetic, nor she has any chronic illness. She does not have drug history. Blood samples were taken a month ago and said that she has a deficit of vitamin D and iron for which she is taking supplements. She is not anemic. Do you really think it is just fungal? What do you mean by excessive contact with water? She is a chef and walks a lot every day.
Hello,
Welcome back to icliniq.com.
Most probably, it is a micro trauma which leads to fungal growth. Excess water contact is one of the aggravation factor of fungal infection and also minor injury or trauma is other factor. Avoid excess contact with water. Biopsy will be required if lesions do not subside after antifungal treatment. Other differential diagnosis is subungal melanoma. If lesion does not improve, biopsy (nail clipping) and histopathology reports will be required to confirm subungual melanoma. Observe the lesion for any change like an increase in size, color, shape, or any symptoms like irritation, burning, itching, and pain on surrounding skin. Revert back.
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Venereology
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