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continued the medication stopped the medication SURMOUNT-4 trial Zepbound (tirzepatide) Same study design, different medication, similar pattern

Pigmented nail lesions can exhibit various colors and sizes, and their origin can be either melanocytic or non-melanocytic.1 In cases of non-melanocytic pigment lesions, such as bacterial or fungal infections and hematomas, clinical findings along with supplementary examinations like dermoscopy, mycological testing, and nail clipping often contribute to a definitive diagnosis.1 Melanocytic pigmentation arises from the deposition of melanin in the nail plate, a condition referred to as true or Longitudinal Melanonychia (LM)

Liver Physiol., 264, G351-G356 11

It does this not by acting as a filler or surface smoother, but by influencing how skin cells behave

10.1021/jf100538t 197 Xiao-FangP.KaWingC.JinyuM.BoC.ChiTangH.CliveL.et al (2008)

Sangria: deep red, scarlet