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JAMA Dermatology Clinicopathological Challenge
November 2016

Longitudinal Erythronychia of the Fingernail

Author Affiliations
  • 1Weill Cornell Medicine, Department of Dermatology, New York, New York
JAMA Dermatol. 2016;152(11):1271-1272. doi:10.1001/jamadermatol.2016.2747

A man in his 70s presented to the clinic with a split in the right fifth fingernail for the past 10 years. He reported paroxysmal, intermittent pain that was exacerbated by cold weather. He fractured the digit more than 30 years earlier. Physical examination revealed distal nail plate splitting with accompanying longitudinal erythronychia (Figure, A) and tenderness on palpation of the nail unit. Magnetic resonance imaging revealed a nail matrix lesion (Figure, B), which was excised using a transungual approach with partial nail avulsion. The specimen was analyzed by histopathology (Figure, C and D).

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