PMC6340236_01
Skin-colored-to-hypopigmented, flat-topped papules in linear configuration along the dorsum of the left thumb along with nail plate thinning, longitudinal ridging, and dystrophy seen. Mild subungual hyperkeratosis and hyperpigmentation of the proximal nail fold
IJD-64-62-g001.jpg
PMC6340236_01_IJD-64-62-g001.jpg
F1
There was nail plate thinning, longitudinal ridging, and complete dystrophy of the lateral aspect of the nail plate [Figure 1].
Epidermis shows mild focal parakeratosis. Enlarged rete pegs expanded around a focus of lymphohistiocytic infiltrate is seen, along with suprapapillary thinning (H and E, x100)
IJD-64-62-g002.jpg
PMC6340236_01_IJD-64-62-g002.jpg
F2
The dermis showed a lymphohistiocytic infiltrate with focally expanded dermal papilla and suprapapillary thinning along with a perivascular lymphocytic infiltrate in a characteristic "claw clutching ball" appearance [Figures 2 and 3].
Higher magnification showing the focal lymphohistiocytic infiltrate at the dermoepidermal junction expanded rete pegs cupping the focus of infiltrate (H and E, x400)
IJD-64-62-g003.jpg
PMC6340236_01_IJD-64-62-g003.jpg
F3
The dermis showed a lymphohistiocytic infiltrate with focally expanded dermal papilla and suprapapillary thinning along with a perivascular lymphocytic infiltrate in a characteristic "claw clutching ball" appearance [Figures 2 and 3].