Differential Diagnosis for Right First Digit Nail Pain
- Single most likely diagnosis
- Onycholysis: This condition is characterized by the separation of the nail from the nail bed, often due to trauma, nail biting, or exposure to harsh chemicals. The symptoms described, such as nail splitting, getting caught, and lifting from the bed, are consistent with onycholysis.
- Other Likely diagnoses
- Onychomycosis: A fungal infection of the nail that can cause discoloration, thickening, and lifting of the nail from the nail bed. The patient's symptoms of nail discoloration and lifting could be indicative of an underlying fungal infection.
- Paronychia: An infection of the skin around the nail that can cause pain, redness, and swelling. Although the primary symptom is pain, paronychia can also lead to nail changes, including discoloration and lifting.
- Nail psoriasis: A condition that affects the nails, causing symptoms such as pitting, thickening, and separation of the nail from the nail bed. The patient's nail splitting and lifting could be related to an underlying psoriatic condition.
- Do Not Miss diagnoses
- Squamous cell carcinoma: A type of skin cancer that can present as a painful, discolored, or thickened nail. Although rare, it is essential to consider this diagnosis to avoid delayed treatment.
- Melanonychia: A condition characterized by a pigmented streak in the nail, which can be a sign of melanoma. Any unusual nail discoloration warrants further investigation to rule out this potentially life-threatening condition.
- Rare diagnoses
- Lichen planus: A condition that can affect the nails, causing thinning, ridging, and brittleness. Although less common, lichen planus could be a consideration if other diagnoses are ruled out.
- Darier's disease: A rare genetic disorder that can cause nail abnormalities, including red and white streaks, and nail lifting. This diagnosis would be unlikely but should be considered if other options are exhausted.