A 60-year-old African American man with a 1.5-year history of a painful, enlarging growth on the tip of his right index finger was referred to our clinic. The patient was otherwise healthy. His personal and family histories were noncontributory.
Examination of the right index finger revealed a well-demarcated, verrucous, friable plaque on the distal, ulnar aspect (Figure 1). The lesion extended subungually. The rest of the examination was unremarkable. A biopsy of the lesion was performed, and the specimen was sent for histologic evaluation (Figure 2 and Figure 3).