Subungual Exostosis on the Right Hallux.

Area of Science:

• Orthopedics
• Dermatology
• Surgical Pathology

Background:

• Subungual exostosis (SE) is an uncommon benign bony growth typically found beneath the nail of the distal phalanx.
• SE presents with two clinical variants: protruded and nonprotruded, requiring different management strategies.

Observation:

• A 15-year-old male presented with a painful, 1-cm protruded growth on his right great toe, penetrating the nail bed and causing deformity.
• Radiographic imaging revealed an elevated mass on the distal phalanx of the hallux.

Findings:

• Histopathological examination confirmed the diagnosis of subungual exostosis.
• Surgical excision of the protruded SE was performed, with no recurrence observed at 6 and 18 months post-operation.

Implications:

• Complete surgical excision is the gold standard treatment for symptomatic subungual exostosis.
• Accurate diagnosis is crucial, requiring differentiation from other bone lesions like osteochondromas and enchondromas.