Last reviewed: June 2020
Last updated: December  2019

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
  • greyish-white or light brown colour
  • 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

Treatment algorithm

Contributors

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 funds in the following roles: as an advisory board member for Janssen and LEO Pharma; as a consultant for Allergan, Biofrontera, Bristol-Myers Squibb and Mayne Pharma; as a clinical study investigator for AbbVie, Aclaris, Allergan, Astellas Pharma, Biofrontera, Boehringer Ingelheim, Bristol-Myers Squibb, Dermavant Sciences, Dermira, Eli Lilly and Company, Foamix Pharmaceuticals, Galderma, Incyte, Janssen, Mayne Pharma, Naked Biome, Novartis, Parexel, Pfizer and Verrica Pharmaceuticals; as a coordinating investigator for Allergan; and as a speaker for AbbVie, Aclaris, Allergan and Almirall.

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

Peer reviewersVIEW 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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