[Skip to Navigation]
Sign In
Views 1,015
Citations 0
JAMA Oncology Clinical Challenge
October 31, 2019

Subungual Mass in a Middle-aged Woman

Author Affiliations
  • 1Department of Dermatology, Peking Union Medical College Hospital, Beijing, China
JAMA Oncol. 2019;5(12):1799-1800. doi:10.1001/jamaoncol.2019.4500

A 54-year-old woman presented with a 7-year history of a painful subungual mass of the right thumb. The lesion was initially believed to be an infection; however, results of both mycological and bacteriologic examinations were unremarkable. The patient had no notable medical history, including dyskeratosis congenita, trauma, sun exposure, radiation exposure, chemical exposure to tar or arsenic or exposure to minerals, chronic immunosuppression, or chronic infection. Physical examination revealed a subungual nodule with some exudation and crusts. The distal nail plate had been destroyed and showed onycholysis with obvious separation from the nail bed (Figure, A). Pertinent laboratory results (complete blood cell count, liver panel, kidney panel) were within normal limits. Lesional biopsy was also performed (Figure, B and C).

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words