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KMID : 0363220090470010043
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Korean Journal of Dermatology
2009 Volume.47 No. 1 p.43 ~ p.49
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The Clinical, Histopathological and Radiological Findings of Subungual Exostosis
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Jeong Ki-Heon
Lee Mu-Hyoung
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Abstract
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Background: Subungual exostosis is a rare, solitary, benign bony tumor of the distal phalanx. It occurs mainly in
the great toe and less frequently in the other toes and fingers. It may cause nail deformity and pain.
Objective: We wanted to describe the clinical, histopathological and radiological features and the recurrence after
treatment of subungual exostosis.
Methods: A total of 12 patients who were diagnosed with subungual exostosis at our hospital from 1997 through
2007 were evaluated.
Results: There were seven females and five males. The average age of the patients at the time of surgery was 24.2±
9.2 years. The mean duration of symptoms was 11±6.0 months. All the patients presented with a solitary, fixed,
hard exophytic tumor beneath the nail plate. Eight patients (67%) presented with a lesion on the great toe, three
patients (25%) with a lesion on the other toes and one patient (8%) with a lesion on the thumb. The histopathology
revealed a fibrocartilaginous cap, enchondral ossification and calcification in all the patients and islands of mature
trabecular bone in ten patients (83%). The radiographic picture showed a typical pattern of a bony excrescence
arising from the dorsal aspect of the distal phalanx. All the patients were treated with surgical excision of the lesion
and eleven patients (92%) showed good results. One patient (8%) had a local recurrence and she underwent
subsequent excision. No additional local recurrences were observed.
Conclusion: Subungual exostosis is unfamiliar to most dermatologists, and it can be difficult to diagnose in some
cases. When a subungual mass is observed, subungual exostosis should be considered in the differential diagnosis
and subsequent radiographic studies along with histologic studies are recommended.
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KEYWORD
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Clinicopathological study, Subungual exostosis
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