Young man’s nails have gray spots and pain, it turns out it’s choroid malformation

Three patients in their 30s had gray shadows on their fingernails, which hurt like an electric shock when touched. The three asked Google and ChatGPT online, and the guessed answer was consistent, which might be choroid malformation. After surgery and pathology reports, the three patients were completely relieved of their symptoms and returned to normal life.

Li Shiyi, director of the Yisimei Plastic Surgery Clinic in Taichung, Taiwan, explained that the three patients were all in their 30s, with different work backgrounds but the same experience. They saw gray-blue dots on different fingernails, which felt like electric shocks to the nerves when they were touched, and lasted for almost half an hour. They went to a dermatologist, who said it might be a nerve problem. They also went to a large hospital for a neurology examination, and the results were normal, which was quite troubling.

Li Shiyi said that when gray-blue dots are found under the nails, about 0.1 to 0.2 cm, and they are severely painful when they are accidentally touched, and they last for more than 30 minutes, and there is no improvement after taking medicine, it should be considered that it may be a choroid malformation. The treatment method is that the prognosis of surgery is very good, and recurrence is rare. It is recommended to find a plastic surgeon who is capable of performing fine microsurgery for treatment.

Lee Shi-yi pointed out that choroidoma is rare. It is a benign tumor that grows from the “globe” deep in the skin and has a temperature-regulating function. It is prone to occur in fingers and toes. The three most typical symptoms are: first, a slight collision will cause severe pain like a needle prick or electric shock; second, temperature sensitivity, the pain will be significantly aggravated by touching ice water or cold weather; third, small blue and red dots may appear under the nails or on the fingertips.

Lee Shi-yi pointed out that because choroidomas are very small and rare, they are easily misdiagnosed as neuralgia or joint problems. He emphasized that if people have the above typical symptoms and painkillers are ineffective, they should seek the help of plastic surgeons with fine microsurgery capabilities. Through surgery to lift the nail and completely remove the tumor, the cure rate can reach 100%, and the recurrence rate is extremely low.