Painful, shiny, red papule near fingernail – Let’s diagnose

A 59-year-old woman visited her doctor concerned about a painful skin lesion near her fingernail that had developed over the past week. On examination, a glistening, hemorrhagic papule was seen at the lateral nail fold with surrounding erythema and edema. The patient did not recall any recent trauma to the finger or exposures to skin irritants. She had a history of advanced non-small cell lung cancer (NSCLC) for which she was currently being treated with erlotinib.

What’s the diagnosis?

1. 1. Cutaneous metastases
   2. Drug-induced paronychia
   3. Felon
   4. Cellulitis

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