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Painful nail with longitudinal erythronychia

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The nature of this patient’s pain and her sensitivity to cold helped us to zero in on a diagnosis.



A 46-year-old Caucasian woman was referred to our dermatology clinic with a one year history of progressively increasing pain radiating from the proximal nail fold of her right middle finger. She denied any history of trauma and noted that the pain was worse when her finger was exposed to cold.

On examination, we noted that there was a red line that extended the length of the nail, beginning at the area of pain and ending distally, where the nail split (FIGURE).

Red line extends from area of pain to area of nail splitting

What is your diagnosis?
How would you treat this patient?

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