Nail Plate Hollowing After a Crab Pinch Injury

The red crab pinched the nail plate, causing a hollow space?

Hello Doctor, I was pinched by a red crab while cooking.
After seeking medical attention and taking medication, the pain has subsided.
However, a week later, I noticed a hollow space in my nail plate.
Is it possible that this is a fungal nail infection? Should I seek medical attention promptly or wait for the nail to heal? I've also been suffering from a cold and have been taking iron supplements, but I'm still not feeling better.
Could this be related to the injury from the crab? Thank you for your response.

Cai Xiaojie, 40~49 year old female. Ask Date: 2019/08/16

Dr. Wu Yuxin reply Dermatology

No lesions were observed, making it difficult to determine the issue.
If this is causing significant distress, please seek medical attention promptly.

Reply Date: 2019/08/16

More Info

After experiencing a crab pinch injury, it’s understandable to be concerned about the subsequent development of a hollowing or separation in the nail plate. This phenomenon can occur due to several reasons, and it’s essential to consider the context of your injury and any accompanying symptoms.

Firstly, the initial injury from the crab pinch could have caused trauma to the nail matrix, which is the tissue under the base of the nail responsible for nail growth. If this area is damaged, it can lead to abnormal nail growth, including the appearance of hollowness or separation in the nail plate. This condition is often referred to as "nail dystrophy" and can manifest in various forms, including ridges, discoloration, or hollowness.

Regarding your concern about a fungal infection, such as onychomycosis (commonly known as "fungal nail infection" or "gray nail"), it’s important to note that while trauma can predispose the nail to infections, the presence of a hollow nail plate does not automatically indicate a fungal infection. Fungal infections typically present with discoloration, thickening, and sometimes crumbling of the nail, rather than just hollowness. However, if the nail appears discolored or if you notice any unusual changes in the surrounding skin, it would be prudent to consult a healthcare professional.

As for your recent illness and the medications you are taking, it is unlikely that your cold or the iron supplements (三鐵藥) are directly related to the nail changes following your injury. However, systemic health can impact nail growth and health. If your body is under stress from illness, it might affect how your nails grow or heal.

In terms of management, if the hollowing of the nail plate is not accompanied by pain, redness, swelling, or other signs of infection, you may choose to monitor the situation for a short period. Nails typically take several months to grow out completely, and any changes resulting from trauma may take time to resolve. However, if you notice any signs of infection, such as increased pain, swelling, or discharge, or if the condition worsens, it is advisable to seek medical attention promptly.

In conclusion, while the hollowing of your nail plate after a crab pinch injury could be a result of trauma to the nail matrix, it is essential to monitor for any signs of infection or worsening symptoms. If you have concerns about fungal infections or if the condition does not improve, consulting a healthcare provider would be the best course of action. They may recommend a physical examination, and if necessary, perform tests to rule out any infections or other underlying conditions.

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