Subungual exostosis is a slow-growing, benign outgrowth of normal bone under the nail that affects the nail unit. The most common location in the foot is the dorsal surface of the distal phalanx of the big toe. Clinically, it can appear in combination with a variety of nail disorders, masking the underlying bone condition, which is frequently unrecognized or misdiagnosed. A new classification system for these lesions is proposed on the basis of the clinical signs and symptoms present during examination and the associated disorders of the nail plate. Also, a therapeutic algorithm that describes surgical approaches to the different presentations of this disorder is presented.
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A Case of Subungual Exostosis Mimicking Verruca Vulgaris.
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Department of Medicine, Division of Dermatology, NorthShore University HealthSystem, Evanston, USA.
Subungual exostosis is a benign bone tumor causing nail deformities and possibly pain for the patient. Etiology includes trauma, infection, and activation of a cartilaginous cyst, more commonly seen in adult patients. Here, we present a case of subungual exostosis in a pediatric patient that initially mimicked subungual verruca vulgaris.
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Subungual exostosis is a relatively rare benign bone tumor that occurs near the distal phalanges of the fingers and toes. Though it is similar to osteochondroma, it can be distinguished by its specific location and lack of communication with the medullary cavity. Although recurrence after surgical excision has been reported, no studies have examined the timing or progression of recurrence, nor have there been reports detailing the chronological imaging findings of recurrent cases.
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Article Synopsis
- Subungual exostosis is a bone growth beneath the nail that can recur if not fully removed, and wide resections may lead to nail deformities.
- A case study discusses a patient with a recurring exostosis treated with marginal resection, skin grafting, and electron-beam irradiation to minimize recurrence and preserve nail structure.
- The results were promising, showing effective healing and good cosmetic outcomes, suggesting that electron-beam irradiation could be beneficial for preventing recurrence after surgery.
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