01 Nov Brown spot on the nail By wasif dev0 Comments A 72-year-old hardware store employee came in for a usual physical examination. His vital signs were normal, and he had no fevers, chills, night sweats, or unintended weight loss. His sole concern was a non-tender lesion on his fingernail that he had discovered three months before. He had not had any recent trauma. A longitudinal melanonychia on the radial edge of the left thumbnail was discovered during physical examination. Over the proximal nail fold, there was brown-black pigmentation. A V-shaped nick in the nail plate was evident at the distal end of the streak, and the pigment tapered distally. Which of the following is the most likely diagnosis, Based on the patient’s medical history and physical examination? Nail matrix hematoma Subungual verruca vulgaris Acral melanoma Pseudomonas aeruginosa infection Melanonychia striata None Time's up Share article:TwitterFacebookLinkedin