Erythronychia - Nail and Distal Digit
Alerts and Notices
Synopsis
Longitudinal erythronychia may be specific to one nail or involve multiple nails.
When longitudinal erythronychia involves one nail, it may be caused by benign conditions, such as onychopapilloma, wart, warty dyskeratoma, glomus tumor, or a solitary lesion of lichen planus. Less commonly, it may be caused by malignancies, such as Bowen disease, invasive squamous cell cancer, melanoma in situ, and basal cell carcinoma.
The most common causes of longitudinal erythronychia involving multiple nails are lichen planus and Darier disease. Less common etiologies are systemic amyloidosis, hemiplegia, graft-versus-host disease, and acantholytic epidermolysis bullosa.
Longitudinal erythronychia presents most commonly in adults around 60 years of age, and the thumb is most frequently involved. It may be asymptomatic or painful. A split nail is an associated physical finding.
Codes
ICD10CM:L60.8 – Other nail disorders
SNOMEDCT:
247518009 – Nail bed finding
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Dermoscopy is helpful to distinguish between these entities. With a subungual hematoma, globules are seen. With longitudinal melanonychia, parallel gray-brown-black lines are seen. With longitudinal erythronychia caused by an onychopapilloma, often the lunula is pink and crisscrossed with telangiectasias.Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:02/14/2017
Last Updated:07/08/2020
Last Updated:07/08/2020
Erythronychia - Nail and Distal Digit