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Acquired elastoma in a subungual location.

Zachary J Wolner1, Tracey N Liebman, Eve J Lowenstein

  • 1Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York. Zachary.wolner@downstate.edu.

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Summary
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This study reports a rare case of acquired subungual elastoma in a renal transplant recipient, presenting as a nail papule with associated nail changes. Histopathology confirmed the diagnosis, highlighting an unusual presentation of this connective tissue hamartoma.

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Area of Science:

  • Dermatology
  • Pathology
  • Nephrology

Background:

  • Elastomas are connective tissue nevi or hamartomas.
  • They can occur in isolation or be associated with syndromes like Buschke-Ollendorff syndrome.
  • Typically present in childhood as papules or nodules on extremities, abdomen, and back.

Observation:

  • An unusual case of an acquired subungual papule was observed in a renal transplant recipient.
  • The papule was associated with koilonychia and distal nail plate dystrophy.
  • This presentation is atypical for elastomas, which usually appear in childhood.

Findings:

  • Histopathologic examination confirmed the subungual papule to be an elastoma.
  • This represents a rare instance of acquired subungual elastoma.
  • The case highlights an atypical manifestation of this connective tissue hamartoma.

Implications:

  • This case expands the known clinical spectrum of elastomas.
  • It underscores the importance of considering elastoma in the differential diagnosis of acquired nail abnormalities, particularly in immunocompromised patients.
  • Further research may elucidate the pathogenesis of acquired subungual elastomas in specific patient populations.