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A 63-year-old man presented to the dermatology clinic with a 1-year history of a painful growth on his right index finger (Figure 1). The patient stated that he first noticed a dark spot under his nail that progressively enlarged causing pain and overlying deformity. The patient denied any trauma to the finger but stated that there was severe pain precipitated by cold water and touch. Physical examination of the right index finger revealed a 1.8 cm x 0.8 cm flesh-colored tumor extruding through the proximal nail plate and extending subungually to the distal nail with associated longitudinal groove of the nail plate. The tumor was exquisitely tender to palpation. The patient was otherwise healthy and denied any weight loss, night sweats, or lymphadenopathy. An excisional biopsy was performed and revealed a well-circumscribed tumor (Figures 2, 3, and 4).
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© 2011 Dermatology Online Journal
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