Subungual exostosis of the third toe

Area of Science:

• Orthopedics
• Dermatology

Background:

• Subungual exostosis is a benign bone tumor under the nail plate.
• It often presents as a painful nodule, particularly on the great toe.
• Misdiagnosis is common, even among specialists like dermatologists.

Observation:

• This case details a subungual exostosis on the third toe of a 32-year-old woman.
• The lesion caused symptomatic disruption of the overlying nail and mechanical irritation.
• Initial presentation mimicked other common nail conditions.

Findings:

• Accurate diagnosis was achieved through patient history and radiographic imaging (roentgenography).
• Surgical excision of the third toe subungual exostosis was performed.
• Histopathological examination confirmed the diagnosis of osteochondroma variant.

Implications:

• This case highlights the importance of considering subungual exostosis in differential diagnoses of nail abnormalities.
• Timely and accurate diagnosis through clinical evaluation and imaging is crucial.
• Surgical management provides effective symptom relief and a low recurrence rate, as demonstrated by the 7-month follow-up.