A 29- year- old woman presented with for subungual hyperkeratotic lesion of the fourth left toenail. Ten years ago, she developed systemic sarcoidosis with lung and cutaneous lesions. The patient required gradually tapered systemic corticosteroids for 4 years and methotrexate for 1 year to control lung disease. Recently, a hyperkeratotic verrucous lesion developed beneath the distal portion of the fourth left toenail plate. There was no history of trauma.
A biopsy specimen of the nail bed revealed epithelioid granulomas in the dermis without central necrosis. Plain radiograph examination was performed. What is your diagnosis? *This case is from Docplexus Editorial Team for educative purpose only Source: Pan African Journal Of Medicine (Detailed source will be revealed with explanation)
