Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • lesion growth over weeks to months
  • round, raised papule
  • tiny black dots on surface of lesion

Other diagnostic factors

  • satellite lesions
  • fingers or nail fold lesions
  • facial lesions
  • fissuring
  • hyperkeratosis
  • grayish-white or light brown color
  • filiform papule with sharp spikes

Risk factors

  • water immersion
  • occupations involving handling of meat or fish
  • nail biting
  • age under 35 years
  • immunocompromised

Diagnostic investigations

Investigations to consider

  • skin biopsy
  • immunoperoxidase stain
  • skin culture
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Director

Arlington Center of Dermatology

Primary Investigator

Arlington Research Center

Arlington

Clinical Assistant Professor

Baylor University Medical Center

Dallas

Clinical Assistant Professor

University of Texas Medical Branch

Galveston

TX

Disclosures

AYM has received grants from Abbvie, Allergan, Amgen, Anacor, Astellas, Centocor, Coherus, Eli Lilly, Galderma, Janssen, Merz, Novan, Novartis, Parexel, Pfizer, Regeneron, and Therapeutics. She has worked as an investigator for Abbvie, Allergan, Amgen, Anacor, Astellas, Centocor, Coherus, Eli Lilly, Galderma, Janssen, Novan, Novartis, Parexel, Pfizer, Regeneron, and Therapeutics. She has served on advisory boards for Abbvie, Aqua, DUSA, Janssen, Merz, and Novartis. She has served as a speaker for Abbvie, Allergan, Aqua, Leo, Merz, and Prestium. She has received honorarium from Abbvie, Allergan, Aqua, DUSA, Janssen, Leo, Merz, Novartis, and Prestium.

Dr Angela Yen Moore would like to gratefully acknowledge Dr Leonid Izikson, the previous contributor to this monograph. LI declares that he has no competing interests.

Peer reviewers VIEW ALL

Dermatologist

Wayne State University School of Medicine

Department of Dermatology

Detroit

MI

Disclosures

BLP declares that she has no competing interests.

Assistant Professor

Department of Pathology and Laboratory Medicine

University of California

Los Angeles

CA

Disclosures

DC declares that he has no competing interests.

Chief Dermatology Resident

University of California

Irvine

CA

Disclosures

JJW declares that he has no competing interests.

Consultant Dermatologist

Dermatology Department

The Great Western Hospital

Swindon

UK

Disclosures

SG declares that he has no competing interests.

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