PMC5831699_01
Whole fingernails and toenails of our patient. Normal toenails except for the second ones which have transverse lamellar splitting (a) and grayish pigmented bands with varying widths and intensities on fingernails, predominantly on right hand; loss of cuticle and erythema of proximal nail folds which can also be seen on both hands (b).
CRIDM2018-3230582.001.jpg
PMC5831699_01_CRIDM2018-3230582.001.jpg
fig1
His fingernails also showed punctate leukonychia; small, blackish linear streaks between hyperpigmented bands; and hyperkeratosis in the hyponychium, which obliterated the distal groove, again predominantly on the right hand (Figure 1, informed consent has been obtained from the patient).
Dermoscopic evaluation of right second nail yields longitudinal gray regular lines on a grayish background, splinter hemorrhages as blackish linear streaks, and true leukonychia as it did not disappear with pressure and hyperkeratosis in hyponychium.
CRIDM2018-3230582.002.jpg
PMC5831699_01_CRIDM2018-3230582.002.jpg
fig2
In addition, the dermoscopic examination clearly revealed hyperkeratosis in the hyponychium and adherence of the nail bed to the nail plate, raising the suspicion of pterygium inversum unguis (Figure 2).