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Subungual Ulcers

Discussion in 'General Issues and Discussion Forum' started by ceridwen, Jul 16, 2014.

  1. ceridwen

    ceridwen Member


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    Hi All,

    I've got a client with PVD, who has developed subungual breakdowns under both hallux nails, the first side has been present for 2-3 months, and the second only 2 weeks. I'm a bit puzzled as to how to proceed with this (eg. cutting back the nail or not; referring back to the vascular surgeon).

    Could anyone point me to any research or quality information on the aetiology, differential diagnoses and treatment options for these?

    Cheers,
    Ceridwen
     
  2. akenne30

    akenne30 Active Member

    Hi Ceridwen,

    I dont have any research on it but when I worked a lot with these ulcers under the nail bed it was more often than not the footwear that caused the problem. Shallow and narrow toeboxes can be a causative factor as well as ill fitting footwear. Have a look at the shoes worn most often.

    Just my tuppence worth
     
  3. Ros Kidd

    Ros Kidd Active Member

    Ring the vascular surgeon, document this, follow the surgeons advice. Photo lesions and document treatment carried out. Most likely cause is trauma from shoes but you may be dealing with a critical deterioration in PVD or both.
    Ros
     
  4. Jvm620

    Jvm620 Member

    Good advice already but also you will need to cut the nail back to see the full extent of the lesion & to debride effectively. Also def refer back to vascular team for assessment.
    Julie
     
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