Subungual hemorrhages. A primary manifestation of diabetes mellitus
P. Iglesias, O. Olmos, J. Sastre, J. J. Diez, M. L. Fernandez and J. Borbujo
Department of Endocrinology, Centro de Salud Juncal, Torrejon de Ardoz, Madrid, Spain.
Subungual hemorrhages may be observed in a variety of systemic diseases and
in some otherwise healthy persons. We describe three male patients who were
referred because of toenail hemorrhages. Analytical investigations showed
hyperglycemia in all the patients. Toenail bilateral hemorrhages were the
first manifestation of previously undiagnosed type II diabetes mellitus in
all cases. Ophthalmologic examination showed signs of background diabetic
retinopathy in all three patients. The existence of retinopathy suggests
that subungual hemorrhages might be due to microvascular involvement and
could herald the presence of diabetes mellitus.
