Discoloration of the nail plate to a dark hue, often black, can arise from a variety of factors. Trauma to the digit, leading to subungual hematoma (blood accumulation under the nail), is a frequent cause. This occurs when small blood vessels rupture beneath the nail, resulting in a darkened appearance as the blood clots. For instance, stubbing a toe or wearing ill-fitting shoes during strenuous activity can precipitate this condition.
Identifying the underlying reason for the darkened nail is important for appropriate management. While a subungual hematoma often resolves on its own as the blood is reabsorbed, persistent or unexplained discoloration warrants further investigation. Early detection of other potential causes, such as fungal infections or, in rare cases, subungual melanoma, enables prompt intervention and potentially improved outcomes. Historically, misdiagnosis or delayed diagnosis of nail conditions has led to unnecessary anxiety and, in some instances, progression of treatable diseases.