Nail pits, onycholysis, oil spots, and subungual hyperkeratosis are seen throughout the spectrum of skin tones. Note to look to the hands to see if there are any signs of psoriatic arthritis. When subungual debris is noted, without other features of psoriasis, onychomycosis should be considered.

It is important to note that if only a solitary nail is involved, you should rule out both benign and malignant neoplasms.

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