Hello! I Just Noticed In My Magnifying Mirror That I

Posted on Fri, 23 Nov 2018

Question: Hello! I just noticed in my magnifying mirror that I have a few black spots under four of my fingernails, and am attaching images of the same. I noticed that the one on my right index finger nail seems to be growing out along with the nail. After looking it up on google I think they may be splinter hemorrhages...? Of course it said on google they could be due to injury, nail psoriasis, or much scarier things like scleroderma and endocarditis (I told myself before I wouldn’t google these things!). Do you think that is what they appear to be and do you feel they are anything to worry about? I recently had an ekg, physical, skin check with my dermatologist, and bloodwork, all was normal. I also had a visit yesterday with my PCP, who listened to my heart and said all was normal.. I do have fibromyalgia, and have been taking more ibuprofen than usual due to achiness and sinus headaches. I also think I may have some nail psoriasis, as my fingernails tend to be brittle and chip at the ends. Do you feel these are anything to worry about, and is it something that can be relatively common? Thank you for you time!!

Answered by Dr. Panagiotis Zografakis (1 hour later)

Brief Answer:
I don't believe it's serious...

Detailed Answer:
Hello,

although diagnosing anything without a complete medical history is not safe these 'lesions' look a lot like subtle injuries. If you're using your hands a lot then an injury is possible. Gardening and various other activities may expose the nails to little injuries that may result in this kind of discoloration.

Endocarditis and the like do require a clinical syndrome to be present (fever, etc) and they're not likely to occur to an otherwise healthy individual. When the 'lesions' move outwards as the nail grows, they're attached to the nail. Splinter hemorrhages do not move and the same applies for melanoma and other serious causes.

I can't say whether you have psoriasis or not. Your nails seem normal to me. If you also have skin lesions (psoriasis may cause some characteristic lesions on the skin) then psoriasis is possible. If the lesions do not disappear as the nail grows then perhaps a dermatologist should take a look in person.

Finally fibromyalgia does not seem relevant.

I hope I've answered your question. Please let me know if you need further assistance.

Kind Regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Panagiotis Zografakis (23 minutes later)

Brief Answer:
they're fairly common

Detailed Answer:
You're welcome!

Such injuries are fairly common to people that use their hands a lot. Housework and cleaning sounds like a good reason to injure the nails. Typing does not but it depends! I can't say how hard you're striking those keys!!

I've seen such lesions in many patients. Injury was the cause in almost all of them. Although I cannot be sure that this is the case with you, I can definitely say that this cause seems very likely.

Kind Regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (13 minutes later)

Thank you so very much Dr. Zografakis, for your kind and reassuring response! All of the lesions do appear to be growing out with the nails, and although I can't seem to think of anything in particular I have been doing to cause little injuries, there are a few things, such as housework and cleaning, and typing very hard on the keyboard, that may very well have caused these. One last question -- have you seen these very often on your patient's nails, that seem to be caused by nothing more than injury to the nails? Thank you again so very much for your time!