Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Department of Infectious Disease, Mayo Clinic, Rochester, Minnesota.
JBJS Case Connect. 2023 Jun 1;13(2). doi: e23.00137. eCollection 2023 Apr 1.
A 62-year-old man presented with a 10-year history of isolated melanonychia striata of his dominant thumb. Surgical biopsy ruled out subungual melanoma but revealed foreign plant material causing chronic infectious melanonychia from multiple pathogens, including Pseudomonas aeruginosa, Escherichia coli, and Candida spp. After removal of the nail plate and thorough debridement, the melanonychial streak resolved completely at 12 months of follow-up.
Bacterial infection is a rarely reported cause of melanonychia, and in addition to surgical pathologic specimens, intraoperative fungal and bacterial cultures should always be obtained for accurate diagnosis of melanonychia striata.
一位 62 岁男性，主因优势拇指孤立性甲条纹状黑色素沉着 10 年就诊。手术活检排除了甲下黑色素瘤，但发现了导致多种病原体（包括铜绿假单胞菌、大肠杆菌和假丝酵母菌属）慢性感染性甲黑色素沉着的异物植物材料。在拔除指甲和彻底清创后，随访 12 个月时甲条纹状黑色素沉着完全消退。
细菌感染是甲黑色素沉着少见的病因，除手术病理标本外，术中还应始终进行真菌和细菌培养，以准确诊断甲条纹状黑色素沉着。
