Tips of fingers that die and then won't heal

[kestal3]

Has anyone seen anything like this before?  Started out as a small spot, then skin and nail turned black and fell off.  The new skin is raw and bloody and won't heal.

[maatson]

Acta Derm Venereol. 1999 Nov;79(6):480-1.
Bullous pemphigoid with permanent loss of the nails.
Namba Y, Koizumi H, Kumakiri M, Hashimoto T, Muramatsu T, Ohkawara A.

Best wishes.

[kestal3]

Thank you for your response.  He has been tested for all of these diseases and infections and all have come back negative.  He has seen his regular doctor, a hand specialist, a dermatologist, rheumotologist, and no one can figure it out.  His doctor seems to think its an autoimmune disease.  A biopsy has not been done yet so maybe that is the next step.  He is going to MUSC in a couple of weeks to see a dermatologist there.  If they can't come up with a diagnosis and treatment he is going to the Mayo Clinic in Jacksonville next.  I will let you know once we get a diagnosis.  Thanks again.

[Bhupinder Kaur, MD]

Hello,
For such fingertips, fungal infection, neuropathy,Scleroderma,Mixed connective tissue disease should be ruled out. It will be best to get it evaluated from a dermatologist and get a KOH examination of the skin scrapings done to rule out any fungal infection and a biopsy skin done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.