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Nov 2011

Onychodystrophy With Associated Polymicrobial Distal Phalanx Osteomyelitis

Author Affiliations

Author Affiliations: Departments of Dermatology (Drs Shackelton and English) and Orthopedics (Dr Goitz), University of Pittsburgh, Pittsburgh, Pennsylvania.

Arch Dermatol. 2011;147(11):1330-1332. doi:10.1001/archdermatol.2011.302

A 56-year-old man with insulin-dependent diabetes presented with a 6-month history of deformity, discoloration, and discomfort of his right middle fingernail. He reported repeated reuse of the same lancet to check his blood glucose but otherwise denied any other trauma to the digit. Clinical examination revealed dusky gray discoloration of the distal lateral third of the nail plate as well as brown, subungual, hyperkeratotic debris (Figure 1A). Purulent discharge was apparent with compression of the nail plate.

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