Graft versus host disease (lichen planus-type changesĪccompanied by longitudinal melanonychia) Nelson's syndrome, hyperthyroidism, and acromegaly) Repeated local trauma from poor footwear or overriding toesĮndocrine disorders (Addison's disease, Cushing's syndrome, Having a thorough knowledge of the various causes of brown-to-black nail pigmentation and using a systematic approach when evaluating clinical cases may help prevent misdiagnosis and ultimately save a life.
Due to diagnostic delays of an average of 2 years, NAM carries a poor prognosis with reported 5-year and 10-year survival rates of 30% and 13%, respectively. Unfortunately, patients with NAM are often initially misdiagnosed. Additionally, other nail pathogens, exogenous substances, and subungual hemorrhage can cause non-melanic brown-to-black nail pigmentation. However, melanonychia is an ambiguous clinical finding that most commonly occurs as a result of benign etiologies such as nail matrix melanocytic activation, nail matrix melanocytic hyperplasia, and nail invasion by melanin-producing pathogens. Dub held a variety of leadership roles at Hartford Life Insurance Company and Unum Life Insurance Company, driving business strategy, claim practices, metric development, and operational excellence.Roughly two-thirds of cases of nail apparatus melanoma (NAM) are characterized by melanin-derived brown-to-black nail pigmentation, or melanonychia.
While with Aetna he also served as the head of claims risk management with responsibility for development of Aetna’s disability claim practices nationally. In this executive-level role he was responsible for designing cross-functional, holistic business development solutions and led initiatives to achieve the company’s strategic business objectives. Most recently, he served as vice president, lead business consultant for Aetna Life Insurance Company. In his new position, Dub will be responsible for creating and advancing Matrix’s growth and absence management service offerings, as well as new product development, research, strategy, data analytics and sales support.ĭub brings more than 20 years of directly related industry experience. Matrix Absence Management, Inc., (Matrix), a market leading integrator of insurance and absence management services, has named Paul Dub vice president, Product Strategy and Development, a newly-created role reporting to Matrix President Kenneth Cope.
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