I know you are not my doctor, but WTF is going on with my thumb ?

February 23, 2021 3:56 PM

Backstory: Nearly 4 years ago, I severely pinched my left thumb between two boards when I was cutting them with a chop saw. It hurt like Hell, but nothing was broken, except the nail which was split midway between the base and tip across the entire width. The base part of the nail was slightly embedded, and the rest of it eventually detached over time. I kind of forgot about it except that I think I have some permanent nerve damage as the tip is slightly numb to the touch, but it really doesn't bother me pain wise.

Fast-forward to 6 months ago: I started feeling an intense itching sensation between the base of the nail and the first knuckle.
It felt kind of like it was inside my thumb, or at least beneath the skin, but it really itched.
Out of frustration, I rubbed it with gusto for several minutes, and a bit of liquid secreted from the cuticle.
The itching subsided, so I cleaned it up with peroxide and alchohol, and put a band aid on it. The next morning there was a
crusty residue (like sleepy eye) where the liquid had come out. I cleaned it again, then soaked it in hot salty water 4-5 times that day.
I repeated this the next day, and it seemed to improve, so I went on my merry way. A month ago it returned, and I started soaking it again,
and continued for a week with this soak, squeeze the liquid out, and clean treatment. At this time (first week) there was an eruption of
the same crusty substance and liquid from the side of the thumb...like a pimple. I became obsessed, and continued doing this for like 10 days.
Towards the end of this time I noticed less and less crust and liquid, and the eruption closed and healed. I appear to have conquered the beast, but there
is a twist: It looks (like) I am losing my nail again. What's going on...any ideas?

posted by lobstah to Health & Fitness (5 answers total)

Best answer: Paronychia?
posted by SageTrail at 4:36 PM on February 23, 2021

Best answer: Paronychia. Except for your lack of recent thumb trauma you describe all of the symptoms. Since it’s gone and come back you might be looking at chronic paronychia so you should follow up with a PCP.
posted by shesdeadimalive at 4:51 PM on February 23, 2021 [1 favorite]

Response by poster: Wow, that was fast. I was certain it was related to the old injury, but now I think it might be from organic gardening wounds. I get thorns all the time from our Rosa Rugosa, or our vicious Black Berries !! Thanks Guys !
posted by lobstah at 5:22 PM on February 23, 2021

Best answer: You did well getting onto it quickly with the hot salty water soak. I failed to do that the first time I experienced paronychia after getting stuck with a box thorn, and it was bloody agonizing.

After I did eventually work out that regular hot salt soak was the Right Thing, the agony subsided as soon as the pus found a way out. A few days after that, the redness, pain and swelling had all gone, and few more days later a new nail started growing out, the early stages of which looked very much like your photo.
posted by flabdablet at 4:39 AM on February 24, 2021

Best answer: Also: I get this all the time on my fingers because I pick at cuticles and have my entire life except when I was getting regular professional manicures. Keep up the hot salty water soak to make the pus drain, cover with neosporin and a bandaid if necessary to keep out junk and keep it clean. I lost my first fingernail in first grade due to this. No lasting evidence - can't tell you which finger 30 years later.

To prevent: wear gloves when gardening, keep very clean, keep nails short and filed, moisturize around nails because then it's less likely to develop hangnails that turn into problems.

When to worry: If infection starts moving up your finger towards your heart, like there's a red line on your finger that indicates infection moving along a vein/artery/nerve/something. Then call your doctor.
posted by Ms Vegetable at 6:41 AM on February 24, 2021