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Photo Quiz

Nail Abnormality With Vertical Streaks

Courtney Humphrey, MD
Lydia Bothwell, BS

American Family Physician. 2026;113(4):391-392.

Author disclosure: No relevant financial relationships.

COURTNEY HUMPHREY MD, FAAFP, St. Luke's Family Medicine Residency, Bethlehem, Pennsylvania

LYDIA BOTHWELL, BS, Lewis Katz School of Medicine at Temple University, Bethlehem, Pennsylvania

Address correspondence to Courtney Humphrey, MD, at courtney.humphrey@sluhn.org.

Author disclosure: No relevant financial relationships.

  1. 1.Haber R, Khoury R, Kechichian E, et al. Splinter hemorrhages of the nails: a systematic review of clinical features and associated conditions. Int J Dermatol. 2016;55(12):1304-1310.
  2. 2.Acosta AS, Jafri Z, Khalil K, et al. Nitrofurantoin-induced splinter hemorrhages: a forgotten culprit. JAAD Case Rep. 2024;47:38-40.
  3. 3.Owen JJ, Long S, Mullinax K, et al. Bevacizumab-induced subungual hemorrhage. Dermatol Online J. 2024;30(5).
  4. 4.Leung AKC, Lam JM, Leong KF, et al. Melanonychia striata: clarifying behind the Black Curtain. A review on clinical evaluation and management of the 21st century. Int J Dermatol. 2019;58(11):1239-1245.
  5. 5.Lallas A, Korecka K, Apalla Z, et al. Seven plus one steps to assess pigmented nail bands (melanonychia striata longitudinalis). Dermatol Pract Concept. 2023;13(4):e2023204.
  6. 6.Sequeira Campos MB, Launico MV. Subungual hematoma drainage. StatPearls. June 24, 2025. Accessed February 26, 2026. https://www.ncbi.nlm.nih.gov/books/NBK482508/
  7. 7.Puckett Y, MacKenzie DN. Subungual melanoma. StatPearls. August 9, 2025. Accessed February 26, 2026. https://www.ncbi.nlm.nih.gov/books/NBK482480/

The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at https://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. Email submissions to afpphoto@aafp.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of Photo Quiz published in AFP is available at https://www.aafp.org/afp/photoquiz.

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