This condition is caused by trauma to the nail bed. When acute it is a painful condition. The pressure under the nail bed can be released by trephining the nail with a red-hot paper clip. However, if a fracture of the distal phalanx is suspected, then trephining will only convert a closed fracture into a compound one - thus it should be avoided.
A history of trauma may be lacking, but in any case, the differential of malignant melanoma must always be borne in mind.
The nail is usually lost several weeks later, but will regrow.
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