The race of the individual affected plays anFungus Hack Reviewimportant role in determining this condition. Dark colored people are more prone to this condition. Other conditions, such as acquired immunodeficiency syndrome, inflammatory disorders of the nail, drug usage, Addisons disease, pregnancy, and trauma are also predisposing factors for black toenail. Laugier-Huntziker syndrome is an uncommon condition in which pigmented lip or genital macules also appear in addition to melanonychia.
Traumatic melanonychia is a very large category which covers people suffering from black toenail. It can occur in any toe, but usually there is a predilection for the nail of the big toe, fourth and fifth toes. The appearance of traumatic melanonychia is usually different from that of cutaneous melanonychia. In traumatic melanonycia, there is a deposition of deoxygenated coagulated blood beneath the toenail, while in other cases usually melanin is responsible for the discoloration.
Whatever the cause may be, black toenail is a clinical condition which requires a complete workup to the reach a definitive diagnosis. The workup starts with taking an appropriate history in which the cause of the discoloration, timing, appearance, and evolution of the toenail color is noted. If there is a history of trauma, the diagnosis and further workup becomes easy, however, if not, then a further investigation is required. Enquiring about the symptoms of systemic diseases discoloring the nails is also important. In addition, the drug history of the patient may also help.