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Longitudinal Erythronychia Secondary to a Wooden Splinter
Travis S Dowdle1, Blayne Fenner1, Dylan Maldonado2
1Dermatology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, USA.
Cureus
|February 15, 2023
Summary
Longitudinal erythronychia (LE), red nail streaks, can signal various conditions. This case reveals a splinter as a rare cause of LE, emphasizing the need for thorough diagnosis.
Area of Science:
- Dermatology
- Nail Disorders
- Pathology
Background:
- Longitudinal erythronychia (LE) presents as red streaks in the nail, often indicating underlying conditions.
- Categorizing LE is crucial as specific types correlate with associated pathologies.
- Type 1A LE, particularly with subungual keratosis, warrants careful evaluation.
Observation:
- A 71-year-old male presented with asymptomatic type 1A LE and subungual keratosis.
- Initial differential diagnoses included squamous cell carcinoma in situ, onychopapilloma, and glomus tumor.
- A nail matrix biopsy was performed for definitive diagnosis.
Findings:
- Dermatopathology confirmed the LE was caused by a wooden splinter.
- This represents the first documented case of LE secondary to a splinter.
- The splinter was located in the distal nail matrix.
Implications:
- Splinters should be considered in the differential diagnosis for longitudinal erythronychia.
- Biopsy of suspicious type 1A LE lesions is essential to rule out malignancies like SCCIS and melanoma.
- This finding expands the known etiologies of nail disorders.
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