Differential Diagnosis for Red, Inflamed Area on Big Toe

• Single Most Likely Diagnosis
  • Paronychia: This is an infection of the skin around the nail, which can be caused by trauma, such as a tire dropping on the foot, and can lead to redness, inflammation, and pain. The patient's history of losing a nail and slow nail growth, along with the recent worsening of symptoms, supports this diagnosis.
• Other Likely Diagnoses
  • Onychomycosis: A fungal infection of the nail, which can cause inflammation, redness, and pain, especially if the nail is damaged or growing slowly. The patient's history of nail loss and slow growth makes this a possible diagnosis.
  • Ingrown Toenail: This condition occurs when the nail grows into the surrounding skin, causing redness, inflammation, and pain. The patient's symptoms and history of wearing steel toe boots, which can put pressure on the toes, make this a possible diagnosis.
  • Cellulitis: A bacterial skin infection that can cause redness, inflammation, and pain, especially if the skin is broken or compromised. The patient's recent worsening of symptoms and history of trauma to the area make this a possible diagnosis.
• Do Not Miss Diagnoses
  • Osteomyelitis: A bone infection that can occur after trauma to the foot, such as a tire dropping on it. This condition can cause pain, redness, and inflammation, and can be serious if left untreated. Although less likely, it is a critical diagnosis to consider due to its potential severity.
  • Gangrene: A condition that occurs when tissue dies due to lack of blood supply, which can be caused by trauma or infection. This is a rare but potentially life-threatening condition that must be considered, especially if the patient has a history of trauma to the area.
• Rare Diagnoses
  • Erythromelalgia: A rare condition that causes burning pain, redness, and heat in the hands and feet. This condition is less likely but could be considered if other diagnoses are ruled out.
  • Gout: A form of arthritis that can cause sudden, severe pain and inflammation in the joints, including the big toe. Although less likely, it is a possible diagnosis to consider, especially if the patient has a history of gout or other forms of arthritis.