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A 60-year-old man described a 15-year history of intermittent drainage from beneath the nail plate of his left long finger. The drainage began years after the subject sustained an injury in which a thorn became embedded beneath the nail. The patient had performed a number of self-debridements over the years. He had taken oral antibiotics on multiple occasions. In the 6 months prior to presentation, the drainage became more constant along with pain and erythema. On presentation, the nail plate had a central, 2-mm defect with granulomatous tissue underneath and longitudinal melanonychia. The nail plate was tender and minimal serosanginous drainage could be expressed. The remainder of the finger and nail complex appeared normal. Radiographs of the finger were normal.

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