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Hi all,
I suspect one of my clients has a subungal verruca. There is now pain with pressure on the thickened nail as well as evidence of increased vasculature. Can anyone suggest ways of ruling out differential diagnoses?
Also, are there any suggestions as to the most effective treatment method?

Cheers.

 

subungual verrucae

I have had several patients over the years with suspicious sunungual lesions. I can only tell you that a few of them were malignant melanoma. This is more frequently being seen particularly in warmer sunny climates.

BIOPSY this ASAP.

 

Do a nail biopsy on this person.This could be a hematoma,as well(of course R/O malignant melanoma).

 

With regards to subungual malignant melanoma...although it is relatively rare, it does indeed exist. Best advice.....if you are not totally sure, biopsy it!