What is the diagnosis for the right great toe, which exhibits erythema (redness) and edema (swelling) to the tip and lateral aspect of the nail fold, tenderness to light touch, and warmth, without drainage?

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Differential Diagnosis for Right Great Toe Condition

  • Single most likely diagnosis
    • Paronychia: This is the most likely diagnosis due to the presence of redness, swelling, and tenderness to the tip of the right great toe and lateral aspect of the nail fold, which are characteristic symptoms of paronychia, an infection of the skin around the nail.
  • Other Likely diagnoses
    • Ingrown toenail: The location and symptoms described could also be consistent with an ingrown toenail, especially if the nail is digging into the surrounding skin, causing inflammation and pain.
    • Cellulitis: Although there's no drainage mentioned, the warmth, redness, and swelling could indicate a cellulitis infection, which is a bacterial infection of the skin and subcutaneous tissues.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Osteomyelitis: Although less common, osteomyelitis (an infection of the bone) could present with similar symptoms, especially if the infection has spread from the skin to the bone. Missing this diagnosis could lead to severe consequences, including bone destruction and sepsis.
    • Septic arthritis: If the infection has spread to the joint, it could cause septic arthritis, a condition that requires immediate medical attention to prevent joint destruction and systemic infection.
  • Rare diagnoses
    • Gout: Although gout typically affects the base of the big toe, it could potentially cause inflammation and pain in the tip of the toe, especially if a urate crystal has formed in that area.
    • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which could potentially be confused with an infection or inflammatory condition.
    • Melanoma: In rare cases, a melanoma (a type of skin cancer) could present as a painful, swollen lesion on the toe, especially if it's located under the nail.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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