A 45-year-old man presented with a 4-month history of dystrophic fingernails and a pruritic rash of the scalp. He had a history of cranial diabetes insipidus that had developed 10 years previously. A computed tomographic scan obtained at that time had shown no hypothalamic or pituitary lesion, and the problem was controlled with intranasal arginine vasopressin.
Examination revealed multiple dystrophic fingernails, with erythematous and hemorrhagic macules and nodules in the proximal aspect of the nail beds (Figure 1). There were multiple perifollicular lesions in the scalp (Figure 2). The findings of the general examination were otherwise normal.
Munro CS, Morton R. Nail and Scalp Lesions in a Man With Diabetes Insipidus. Arch Dermatol. 1998;134(11):1477-1482. doi: