Nail disorders: subungual melanoma: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Nail disorders: subungual melanoma

Sample item

A 60-year-old has a longitudinal dark band in the thumbnail that has widened, with pigment extending onto the proximal nail fold. What is this sign?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Hutchinson sign, suggesting subungual melanoma

Hutchinson sign is periungual spread of pigment and strongly suggests acral or subungual melanoma, so urgent biopsy of the nail matrix is needed. Benign melanonychia in dark-skinned people is usually multiple and uniform.

Option by option

  • A. Lindsay nails

    Lindsay nails (half and half) occur in renal failure.

  • B. Terry nails

    Terry nails are white nails with a distal dark band in cirrhosis.

  • C. Osler node

    Osler nodes are painful nodules in endocarditis.

  • D. Hutchinson sign, suggesting subungual melanoma (correct)

    Correct. Pigment extension to the nail fold is Hutchinson sign.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Hutchinson sign, suggesting subungual melanoma. Hutchinson sign is periungual spread of pigment and strongly suggests acral or subungual melanoma, so urgent biopsy of the nail matrix is needed.

Why is "Lindsay nails" not the answer?

Lindsay nails (half and half) occur in renal failure.

Why is "Terry nails" not the answer?

Terry nails are white nails with a distal dark band in cirrhosis.

Why is "Osler node" not the answer?

Osler nodes are painful nodules in endocarditis.

What concept does this question test?

It tests Nail disorders: subungual melanoma in Dermatology. Benign melanonychia in dark-skinned people is usually multiple and uniform.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nail disorders: subungual melanoma?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.