Nail Disease: Clinical Pearls from Phoebe Rich

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  1. In a patient with chronic onycholysis with oozing that is unresponsive to therapy, consider Bowen’s disease of the nail bed.
  2. A thickened nail with white longitudinal and channels with splinter hemorrhages are likely to be an onychomatricoma.
  3. Brittle nails can be caused by or exacerbated by anemia and hypothyroidism.
  4. New onset pincer nails can be drug induced, the most common of which is beta blockers.
  5. A strong association of subungual glomus tumors and type 1 Neurofibromatosis has been identified.
  6. Longitudinal erythronychia (red band in the nail) is most commonly due to an onychopapilloma but other rare causes include SCC and amelanotic melanoma.