Assessing abnormal nails

THERE are various conditions that can cause pigmentation changes or dystrophy of the nail apparatus (Figure 1) and these should serve as a red flag for a possible underlying sinister process when a single nail is involved. 

Blood may be due to trauma but haemorrhage may also occur as a complication of malignancy, and benign haemorrhage should not be assumed without both a clear history of appropriate trauma and confirmed proximal clearing over an interval of time.