Differential Diagnosis for Red, Puffy Side of Toenails

• Single Most Likely Diagnosis
  • Paronychia: This is an infection of the skin around the nail, which can cause redness, swelling, and sometimes pus. It's a common condition that can be caused by bacterial or fungal infections, often resulting from nail biting, picking, or trauma to the nail.
• Other Likely Diagnoses
  • Ingrown Toenail: This condition occurs when the nail grows into the surrounding skin, causing pain, redness, and swelling. It's more common in the big toe and can be caused by improper nail trimming, tight shoes, or genetic predisposition.
  • Eczema/Dermatitis: Skin conditions like eczema or dermatitis can cause redness and swelling around the toenails due to allergic reactions or irritants.
  • Psoriasis: A chronic skin condition that can cause red, scaly patches on the skin, including around the nails, leading to swelling and pain.
• Do Not Miss Diagnoses
  • Cellulitis: A bacterial skin infection that can cause redness, swelling, and warmth of the skin. It requires prompt antibiotic treatment to prevent serious complications.
  • Osteomyelitis: An infection of the bone, which can occur if an infection around the nail spreads to the bone. It's a serious condition that requires immediate medical attention.
  • Squamous Cell Carcinoma: A type of skin cancer that can present as a non-healing sore or red, scaly patch around the nail. Early detection is crucial for effective treatment.
• Rare Diagnoses
  • Sarcoidosis: A condition that can cause small, inflamed bumps to form on the skin, including around the nails, due to an abnormal immune response.
  • Lupus: A chronic autoimmune disease that can cause a variety of skin symptoms, including redness and swelling around the nails.
  • Vasculitis: Inflammation of the blood vessels, which can cause a range of symptoms including skin lesions and nail changes.