Almost all patients present with toe pain.
The lesion is often painful, draining, foul-smelling, causing discomfort and disability if left untreated ranging from simple difficulty walking to a complete inability to walk.
The most severe cases of ingrown toenail present with chronic granulation formation and hypertrophy of the nail fold.
Physical examination results may vary depending on the stage of the disease.
The initial presentation (stage 1) is characterized by signs of inflammation in the affected big toe: pain, swelling, and erythema.
The initial stage is followed by an acute infection with seropurulent drainage and nail fold ulceration, causing more edema and tenderness (stage 2).
Chronic infection then leads to the formation of hypertrophic granulation tissue, which increases the compression and thus adds to the swelling and discharge (stage 3).