Intended for healthcare professionals

Endgames Case Review

Discoloured finger in a young girl

BMJ 2022; 377 doi: (Published 18 May 2022) Cite this as: BMJ 2022;377:e070336
  1. Yuan Yuan Xiao, dermatologist,
  2. Ya Bin Zhou, dermatologist
  1. Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing, China
  1. Correspondence to: Y B Zhou chouyabin{at}

A 3 year old girl presented with a one month history of progressive skin discoloration on the index finger of her right hand. Her parents denied any injury or insect bite and did not mention pain, itching, or paraesthesia. The parents reported that their daughter habitually rubbed her scalp with this finger. Physical examination showed a brown patch on the fingertip (fig 1). The other fingers and nails and oral mucosa, teeth, and eyes …

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