case_images: PMC10625817_01
case_images: Clinical image of left fingernails (a) and right fingernails (b) exhibiting proximal yellowing and longitudinal ridging, with right thumbnail (c) exhibiting proximal yellow discoloration, subungual hyperkeratosis, and v-shaped nicking.
case_images: cde-2023-0015-0001-533386_F01.jpg
case_images: PMC10625817_01_cde-2023-0015-0001-533386_F01.jpg
case_images: F1
case_images: On physical examination, his fingernails exhibited longitudinal ridging and white-yellow discoloration proximally (shown in Fig. 1a, b), as well as onycholysis, subungual hyperkeratosis, and v-shaped nicking of his right thumbnail (shown in Fig. 1c).
case_images: Histopathology (H&E section, x100) of nail biopsy specimen showing a pauci-inflammatory area of epidermal-dermal separation with overlying hyperkeratosis.
case_images: cde-2023-0015-0001-533386_F02.jpg
case_images: PMC10625817_01_cde-2023-0015-0001-533386_F02.jpg
case_images: F2
case_images: A longitudinal excision of the left thumbnail was performed, with histopathology showing a cell-poor subepidermal bulla (shown in Fig. 2) in association with a focal lymphocyte-mediated interface dermatitis and colloid body formation (shown in Fig. 3).