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What Could A Dark Vertical Band On Thumb Nail After Stress Fracture Be?

Posted on Mon, 4 Aug 2014

Question: Im a 64 year-old athletic female, 95 lbs, 157 cm. recently sustained 3 stage 3 stress fractures during running and triathlon training. Was swimming 5000 meters a day outside until cast was put on my rt leg to heal the stress fx in my tarsus, calcaneous and navicular of my right
foot. Ive been in a cast for 3 weeks and lost 7 lbs.
I have a dark vertical band in my left thumb nail since the beginning if this year. The band apoears to have widened but Im not sure. What is your differential diagnosis? XXXX

Answered by Dr. Gaurav Katiyar (1 hour later)

Brief Answer:
Melanonychia

Detailed Answer:
Hi,

I have gone through your query and pictures of the nail.

There is a longitudinal dark band on your nail which is called Melanonychia. There are various causes of this condition like:
Physiologic longitudinal melanonychia
Systemic disorders
Trauma
Inflammatory disorders
Fungal infections
Drugs
Benign melanocytic hyperplasias.

But most concerning cause is Subungual Melanoma. In cases of Subungual Melanoma (Dangerous type of cancer), there is history of long standing dark band with recent change in Color , size or pattern and you have said that it increased in size.
But other causes need to be ruled out first by clinical examination and investigations. I advise you to visit a dermatologist and get it inspected.

Hope i have answered your query.
Wish you good health and recover from Stress fracture soon.

Regards
Dr. G.Katiyar

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Gaurav Katiyar (2 hours later)

Thank you. I will fillow-up with a dermatologist. Can you tell me what drugs can cause this?

Answered by Dr. Gaurav Katiyar (14 hours later)

Brief Answer:
Various drugs mentioned below

Detailed Answer:
Hi,

Thanks for the follow-up. I am glad that you will see your dermatologist soon.
Yes, there are some drugs (Medicines) which may cause Melanonychia. I have mentioned some drugs known to be associated to your present condition:

Chemotherapy agents like:
Bleomycin sulfate
Busulfan
Cyclophosphamide
Dacarbazine
Daunorubicin hydrochloride
Doxorubicin
Etoposide
5-fluorouracile
Hydroxyurea
Imatinib
Melphalan hydrochloride
Methotrexate
Nitrogen mustard
Nitrosourea
Tegafur

Other include:
ACTH
Amodiaquine
Amorolfine
Arsenic
Chloroquine
Clofazimine
Clomipramine
Cyclones
Fluconazole
Fluorides
Gold salts
Ibuprofen
Ketoconazole
Lamivudine
Mepacrine
Mercury
MSH
Minocycline
PCB
Phenytoin
Phenothiazine
Psoralen
Roxithromycin
Steroids
Sulfonamide
Thallium
Timolol
Zidovudine

Hope I have answered your query. You may close the query and rate the answer.

Wish You good health
Regards
Dr. G.Katiyar

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju