A 60-year-old man presented with a 2-weeks history of darkening and tenderness of fingernails. He was diagnosed with local advanced squamous cell lung cancer and initiated neoadjuvant chemotherapy (nab-paclitaxel, carboplatin) plus pembrolizumab 2-months ago. The patient didn't experience fingernails injury and had no history of antithrombotics or anticoagulants. Besides, his platelet counts and coagulation functions were within normal range during chemotherapy. On physical examination, subungual haematomas involving a large portion of ten fingernails (Fig.