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Maj Brian C. Leach, MC, USAF; LCDR Bradley S. Graham, MC, USN
Naval Medical Center San Diego, San Diego, Calif

Arch Dermatol. 2004;140:1003-1008.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 26-year-old white woman presented with a 15-month history of a slowly enlarging papule involving the proximal nail fold of her left thumb. She gave no history of trauma to the region and denied any ulceration or bleeding. Although the lesion had caused disfigurement of her nail, she sought medical evaluation only because the lesion had recently become slightly painful on palpation.

Physical examination revealed a 4-mm, smooth, hyperpigmented papule overlying the medial proximal nail fold of the left thumb (Figure 1). The lesion was soft, with a gray-pink hue, and slightly tender to palpation. Longitudinal grooving of the nail plate was observed distal to the papule (Figure 2). A skin biopsy specimen was obtained (Figure 3 and Figure 4).

Figure appears in full text version. Figure 1.

Figure appears in full text version. Figure 2.

Figure appears in full text version. Figure 3.

Figure appears in full text version. Figure 4.

What is your diagnosis?

SECTION EDITOR: MICHAEL E. MING, MD

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