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July 2007

A Blue-Gray Subungual Discoloration—Quiz Case

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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Dermatol. 2007;143(7):937-942. doi:10.1001/archderm.143.7.937-d

A 34-year-old white woman presented with a 10-year history of pigmentation of the second right fingernail. A blue-gray, well-limited, semicircular spot was seen in the middle of the lunula (Figure 1). Superficial linear erosion of the nail plate extended from the distal part of the tumor process to the distal nail plate. Hutchinson sign was absent. Dermoscopic examination revealed a homogeneous blue discoloration on the distal matrix, with a few linear hemorrhages on the nail plate (Figure 2). There was no clear history of local trauma. Only 1 finger was affected. An x-ray film of the phalanx showed no abnormalities.

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