ABSTRACT
<p><b>INTRODUCTION</b>A subungual exostosis (SE) is a bony overgrowth that is permanently attached to the tip of the distal phalanx. Its pathology differs from osteocartilaginous exostoses in that it mainly involves the overgrowth of normal bone, which may present beneath the toenail or on the sides of the toe. This retrospective study aimed to report the results of surgical treatment when the diagnosis of SE was delayed; the condition was initially considered to be another pathology affecting a different nail or the terminal toe.</p><p><b>METHODS</b>A total of 17 patients (12 female, five male) were included in the study. All surgical resections were performed by the same surgeon using the same surgical technique, with the patient under digital anaesthesia. The patients were evaluated pre- and postoperatively (on Weeks 1 and 6, the first year, and the last follow-up visit) using the American Orthopaedic Foot and Ankle Society questionnaire and the Visual Analogue Scale score.</p><p><b>RESULTS</b>The patients underwent surgery for SE removal between December 2009 and October 2012. Their mean age was 21.3 ± 4.4 (range 14-29) years and the mean follow-up period was 27.1 ± 7.8 (range 18-45) months. Clinical or radiological recurrence was not observed in any of the patients during the follow-up period. Four patients had superficial infections, which were treated using appropriate antibiotic therapies.</p><p><b>CONCLUSION</b>As SE is an uncommon benign lesion, its diagnosis may be delayed. Radiography may be useful in obtaining a differential diagnosis.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Bone Neoplasms , Diagnostic Imaging , General Surgery , Cartilage , Diagnostic Imaging , General Surgery , Diagnosis, Differential , Exostoses , Diagnostic Imaging , General Surgery , Nail Diseases , Diagnostic Imaging , General Surgery , Nails , General Surgery , Orthopedics , Methods , Pain Measurement , Postoperative Period , Recurrence , Retrospective Studies , Surveys and QuestionnairesABSTRACT
BACKGROUND: Subungual exostosis is a rare, solitary, benign bony tumor of the distal phalanx. It occurs mainly in the great toe and less frequently in the other toes and fingers. It may cause nail deformity and pain. OBJECTIVE: We wanted to describe the clinical, histopathological and radiological features and the recurrence after treatment of subungual exostosis. METHODS: A total of 12 patients who were diagnosed with subungual exostosis at our hospital from 1997 through 2007 were evaluated. RESULTS: There were seven females and five males. The average age of the patients at the time of surgery was 24.2+/-9.2 years. The mean duration of symptoms was 11+/-6.0 months. All the patients presented with a solitary, fixed, hard exophytic tumor beneath the nail plate. Eight patients (67%) presented with a lesion on the great toe, three patients (25%) with a lesion on the other toes and one patient (8%) with a lesion on the thumb. The histopathology revealed a fibrocartilaginous cap, enchondral ossification and calcification in all the patients and islands of mature trabecular bone in ten patients (83%). The radiographic picture showed a typical pattern of a bony excrescence arising from the dorsal aspect of the distal phalanx. All the patients were treated with surgical excision of the lesion and eleven patients (92%) showed good results. One patient (8%) had a local recurrence and she underwent subsequent excision. No additional local recurrences were observed. CONCLUSION: Subungual exostosis is unfamiliar to most dermatologists, and it can be difficult to diagnose in some cases. When a subungual mass is observed, subungual exostosis should be considered in the differential diagnosis and subsequent radiographic studies along with histologic studies are recommended.
Subject(s)
Female , Humans , Male , Congenital Abnormalities , Diagnosis, Differential , Exostoses , Fingers , Islands , Nails , Recurrence , Thumb , ToesABSTRACT
Subungual exostosis is a benign, acquired tumor of cartilaginous bone which occurs beneath the nail of the distal phalanx, and can often lead to displacement and deformity of the overlying nail. Complete surgical excision is a curative treatment for subungual exostosis. Since there have been no case reports of complete surgical removal of subungual exostosis in the Korean dermatologic literature, we report four cases of subungual exostosis that were successfully treated through complete excision or excision in combination with additional curettage.
Subject(s)
Congenital Abnormalities , Curettage , ExostosesABSTRACT
Subungual exostosis is a benign osteochondral tumor usually involving the distal phalanx of the great toe. It rarely occurs on other toes or the fingers. We report a case of a 26-year-old male who presented with a growing painful nodule on his right 4th finger. Diagnosis was confirmed by radiologic and histopathologic studies, followed by complete excision of the lesion. At the 13-month follow-up, there was no sign of recurrence. We think that subungual exostosis should be considered in the differential diagnosis of any digital mass.
Subject(s)
Adult , Humans , Male , Diagnosis , Diagnosis, Differential , Exostoses , Fingers , Follow-Up Studies , Recurrence , ToesABSTRACT
Subungual exostosis is an uncommon benign tumor of cartilaginous bone arsing adjacent to the distal phalanx of a digit. It is usually a solitary lesion that develops most often in substance of the great toe and less frequently in other toes. The rare presentation of subungual exostosis in a finger usually stimulates an extensive differential diagnosis. We present a case of subungual exostosis of the finger in a 54-year-old female. Roentgenographic findings showed stick-like calcified density on the tip of the distal phalanx of the left 5th finger. Histopathologic findings showed enchondral bone structure and surroundung cartilaginous tissues in the dermis. At 6-month follow-up, the result was excellent, with no sign of recurrence.
Subject(s)
Female , Humans , Middle Aged , Dermis , Diagnosis, Differential , Exostoses , Fingers , Follow-Up Studies , Recurrence , ToesABSTRACT
Subungual exostosis is a bony outgrowth occuring on the distal phalanx beneath the nail. This report concerns a case of subungual exostosis, accompanied with overlying myrmecia which developed in a 18-years-old man. Confirmatory X-ray showed a bony exostosis arising from the dorso-medial aspect of the distal end of the distal phalanx of the right great toe. The purpose of this artiicle is to direct attention to subungual existosis, the diagnosis of which may often be unsuspected in dermatology
Subject(s)
Dermatology , Diagnosis , Exostoses , ToesABSTRACT
Subungual exostosis is a bony outgrowth occuring on the distal phalanx beneath the nail. This report concerns a case of subungual exostosis, accompanied with overlying myrmecia which developed in a 18-years-old man. Confirmatory X-ray showed a bony exostosis arising from the dorso-medial aspect of the distal end of the distal phalanx of the right great toe. The purpose of this artiicle is to direct attention to subungual existosis, the diagnosis of which may often be unsuspected in dermatology
Subject(s)
Dermatology , Diagnosis , Exostoses , ToesABSTRACT
Subungual exostosis are not uncommon, however, they are infrequently mentioned in the dermatologic literature. We report herein a rase of subungual exostosis in the great toe of 16-year-old female student which was confirmed by histopathologic and radiologic findings. Histopathologic examination showed that the mass was ooeered by a dense fibrous tissue which merged into a fibrocartilage cap and bone. Computed tomography showed a well defined, oval shaped, radiopacity of bony density capped by a radiolucency.