Cause of black toe unknown

DEAR DR. GOTT: My left big toe is black 90 percent of the time. I assume this is a circulation problem. My GP said it was no big deal. (He didn’t look at it.) I wonder what your opinion is. I’m a 54-year-old male and very active. Thanks.

DEAR READER: Two hints from the minimal information you gave me — specifically that 10 percent of the time your toe is not black and that you are very active — lead me toward possible stress placed on your feet, primarily the big toe. In essence, you could have impact trauma from pushing your toe to the front of your shoe(s) when walking, running, or engaging in sports activities such as baseball, soccer and football. I must rule out a melanoma under the toenail or a fungal infection, because both conditions would be present 100 percent of the time.
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