September 2022 - Q&A Case What's the Diagnosis?

Author:
Mike Casteel, DPM, FACPM, FAPWHc

 

HPI
50 y/o male presented to the clinic with a complaint of a “thickened fingernail, right pointer finger”, present for approximately 2 years. Patient relates no history of trauma to the nail and no previous skin cancer. Occupation: accountant.
Past Medical History
Hypertension
Past Family / Surgical History
Non-contributory
Physical Exam
The right 2nd fingernail is positive for
  • Xanthonychia
  • Longitudinal over-curvature of the nail plate
  • “Honey-comb” appearance of the distal aspect of the nail plate
  • Splinter hemorrhaging

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