Subungual exostosis

Subungual exostoses are bony projections which arise from the dorsal surface of the distal phalanx, most commonly of the hallux (the big toe).[2]

Subungual exostosis
Other namesDupuytren subungual exostosis[1]
Subungual exostosis (1/3), in a boy of 15 years old
SpecialtyOrthopedic

Presentation

They tend to be painful due to the pressure applied to the nail bed and plate. They can involve destruction of the nail bed.[3] These lesions are not true osteochondromas, rather it is a reactive cartilage metaplasia. The reason it occurs on the dorsal aspect is because the periosteum is loose dorsally but very tightly adherent volarly.[4]

Subungal malignant melanomas can also occur in canines.

They are distinct from subungual osteochondroma.[5]

Diagnosis

Treatment

Surgical excision is common and is a very effective mode of treatment.

  • Subungual exostosis (2/3)
  • Subungual exostosis (3/3), after excision

See also

References
  1. "Dupuytren subungual exostosis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 11 October 2017.
  2. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  3. Suga H, Mukouda M (2005). "Subungual exostosis: a review of 16 cases focusing on postoperative deformity of the nail". Annals of Plastic Surgery. 55 (3): 272–5. doi:10.1097/01.sap.0000174356.70048.b8. PMID 16106166.
  4. Murphey MD, Choi JJ, Kransdorf MJ, et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics 20:1407-1434, 2000
  5. Lee SK, Jung MS, Lee YH, Gong HS, Kim JK, Baek GH (2007). "Two distinctive subungual pathologies: subungual exostosis and subungual osteochondroma". Foot & Ankle International. 28 (5): 595–601. doi:10.3113/FAI.2007.0595. PMID 17559767.
Classification


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