Differential Diagnosis for Vertical Brown-Red Color Lines on Nails
Single Most Likely Diagnosis
- Melanonychia: This condition is characterized by the appearance of brown or black pigmentation in the nail plate, often in the form of vertical stripes. It can be caused by a variety of factors, including nail trauma, infection, or systemic diseases. Given the sudden onset of vertical brown-red color lines on the nails, melanonychia is a plausible diagnosis.
Other Likely Diagnoses
- Nail Trauma: Trauma to the nail bed can cause bleeding under the nail, leading to the formation of brown or red lines. This is a common and relatively harmless condition.
- Fungal Infections: Fungal infections of the nail, such as onychomycosis, can cause changes in nail color, including brown or red discoloration.
- Nail Psoriasis: Psoriasis can cause nail changes, including pitting, thickening, and discoloration, which may appear as brown or red lines.
Do Not Miss Diagnoses
- Subungual Melanoma: Although rare, subungual melanoma is a type of skin cancer that can present with pigmentation changes in the nail. It is essential to rule out this diagnosis, as it can be life-threatening if left untreated.
- Endocarditis: Infective endocarditis can cause embolic phenomena, including splinter hemorrhages, which may appear as red or brown lines under the nails.
Rare Diagnoses
- Addison's Disease: This rare endocrine disorder can cause hyperpigmentation, including nail changes, due to increased levels of adrenocorticotropic hormone (ACTH).
- Peutz-Jeghers Syndrome: This genetic disorder is characterized by the development of benign polyps in the gastrointestinal tract and mucocutaneous melanin deposits, which can cause nail pigmentation changes.
- Laugier-Hunziker Syndrome: This rare condition is characterized by hyperpigmentation of the nails, lips, and oral mucosa, often with a vertical or longitudinal pattern.