ONYCHOMATRICOMA

By Gary M. White, MD


Onychomatricoma is a rare benign tumor originating from the germinal matrix of the nail.

Clinical

Onychomatricoma may present in several ways:

  1. Longitudinal melanonychia.
  2. Yellowish discoloration of a longitudinal segment of the nail plate (xanthonychia) with small splinter hemorrhages within the proximal portion of the nail.
  3. Thickening with increased transversal curvature of the involved nail plate.
  4. Matrix tumor consisting of multiple fine filiform projections that extend into the thickened nail plate.

The onychomatricoma has a distinct honeycomb pattern after clipping the nail. Fingers are more commonly affected than toes. It is most common in middle-aged to older individuals.

Treatment

Complete excision may be done.

References

An. Bras. Dermatol. vol.90 no.2 Rio de Janeiro Mar./Apr. 2015

Onychomatricoma presenting with multiple splinter hemorrhages. BJD 2015;173;1305–1307

A 27-year-old woman with an 8-year history of gradual nail dystrophy on the right index finger, which was initially misdiagnosed as onychomycosis; she had been treated for 4 years with antifungal agents by general physicians without improvement. On physical examination, the nail plate of the right index finger was thickened and dark yellowish in color, mimicking onychomycosis. It exhibited scattered splinter hemorrhages and overcurvature in the longitudinal plane [Ann Dermatol. 2016 Apr; 28(2): 237–241].

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