Thin dark lines beneath the fingernails are the only physical findings of note in a middle-aged man who presents with cough, fevers, and arthralgias.
A 42-year-old man presents with nonproductive cough and subjective fevers and chills with associated arthralgias of 2 weeks’ duration. He admits to a history of intravenous drug use and hepatitis C. He uses daily alcohol and tobacco and currently takes no prescription or over-the-counter medications.
Vitals signs: temperature, 38.3°C (100.9°F); heart rate, 101 beats/min; respiratory rate, 18 breaths/min; blood pressure, 112/72 mm Hg; oxygen saturation, 96% on room air.
His cardiopulmonary examination reveals clear lungs, with a grade II/VI systolic ejection murmur. The rest of his physical exam is unremarkable except for some lesions under the fingernails similar to those shown in the Figure above.
1. What is this dermatologic manifestation?
2. What diagnosis might this finding suggest in this patient?
Please click here for answer and discussion.
Atopic Dermatitis: The Pipeline and Clinical Approaches That Could Transform the Standard of Care
September 24th 2025Patient Care tapped the rich trove of research and expert perspectives from the Revolutionizing Atopic Dermatitis 2025 conference to create a snapshot of the AD care of the future.