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BOSTON -- The threshold for biopsying unexplained nail dystrophy or discoloration should be low, according to Dr. Phoebe Rich.
Although the majority of nail unit lesions are benign, "malignancies are not as obvious to spot clinically as you would think," and a missed or delayed diagnosis can be life threatening, Dr. Rich said at the American Academy of Dermatology's Academy 2009 meeting.
Any unexplained solitary, painful, dystrophic nail, particularly in an elderly patient, should be biopsied to rule out squamous cell carcinoma of the nail bed.
