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JAMA Dermatology Clinicopathological Challenge
February 2014

A Gray Pigmented Band of the Third Fingernail With Distal Splitting

Author Affiliations
  • 1Saint Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
JAMA Dermatol. 2014;150(2):199-200. doi:10.1001/jamadermatol.2013.5731

A white man in his 60s was referred to our unit for a troublesome nail dystrophy on the third digit of the right hand. The patient placed the inception of onychodystrophy at around 10 months prior to consultation. The physical examination revealed a grayish longitudinal band of the lateral side of the nail (3 mm in width) with splitting of the distal margin (Figure, A-C). Dermoscopy of the band showed lack of homogeneity in pigmentation, with interrupted lines with different colors and blurred lateral borders. Irregularly shaped brown to black spots were present in a random pattern in the length of the band (Figure, D).

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