A 26-year-old woman notes the insidious onset of an abnormal nail. The nail plate gradually grew away from the underlying nail bed and then began to elevate in a tented fashion.
A 26-year-old woman notes the insidious onset of an abnormal nail. The nail plate gradually grew away from the underlying nail bed and then began to elevate in a tented fashion. The patient cut away the distal nail plate and found a papular lesion under the nail that pushed the latter upwards.
Key point: This rough-surfaced subungual papule also shows dilated, thrombosed blood vessels within it (black dots). This is characteristic of a wart.
Treatment: The nail plate was removed and the subungual mass removed by sharp curettage. The resulting bloody defect was elecrodesiccated, and the nail allowed to heal back by secondary intention. By 9 months later, the entire nail had re-grown in proper position.
Note: Subungual squamous cell carcinoma can closely simulate subungual verucca vulgaris, and a small biopsy is indicated before definitive treatment is given.
Biden Administration Announces First 10 Prescription Drugs Slated for Price Negotiations
August 29th 2023The first 10 drugs identified for negotiations under the Inflation Reduction Act include several well advertised agents indicated to treat diabetes, heart failure, and other chronic diseases.