What is Hutchinson's sign associated with?

• A. Subungual melanoma
• B. Psoriasis
• C. Onychomycosis
• D. Dermatophyte infections

Answer: (A)

Hutchinson's sign is specifically associated with subungual melanoma. This sign refers to the presence of pigmentation extending from the nail bed onto the cuticle or proximal nail fold, which is a concerning indicator that can suggest a malignant process, particularly melanoma. When evaluating a patient with nail changes, the detection of this sign raises significant concern for melanoma, as it can indicate that the tumor has invaded the nail or surrounding tissue.

In contrast, conditions such as psoriasis, onychomycosis, and dermatophyte infections do not exhibit Hutchinson's sign. Psoriasis may present with a variety of nail changes, including pitting and onycholysis, but the specific pigmentary change seen with Hutchinson's sign is not characteristic. Onychomycosis, caused by fungal infections, manifests with discolored and thickened nails but does not show the specific sign indicative of cancer. Dermatophyte infections affect the keratin structure but do not produce the pigmented changes associated with Hutchinson's sign. Thus, recognizing Hutchinson's sign in a clinical setting is critical for prompt diagnosis and potential intervention for subungual melanoma.