Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, localized, paroxysmal pain beneath the nail plate of the [Digit]. Reports exquisite sensitivity to cold temperatures and localized tenderness to light touch. No history of trauma. Pain is described as throbbing and severe, often interfering with daily activities and sleep.
Clinical Examination Findings
Examination of the [Digit] reveals a subtle, bluish-red discoloration visible through the nail plate. Loveโs pin test is positive, eliciting sharp pain upon focal pressure with a pinhead. Hildrethโs sign is positive, with reduction in pain following digital tourniquet application. Cold sensitivity test is positive. No signs of infection or nail dystrophy.
Treatment Protocol
Recommended treatment is surgical excision of the glomus tumor via a transungual or lateral subungual approach. The nail plate is elevated, the tumor is identified and excised, and the nail bed is repaired with fine absorbable sutures. Post-operative care includes elevation, dressing changes, and activity modification.