Courtesy Stephen H. Goldberg, MD
A subungual exostosis is an overgrowth of the underlying bone that pushes up the nail and appears as a dermal skin nodule. Many clinicians have biopsied the skin without diagnostic reward. Only and X-ray will reveal the cause. Subungual exostosis a variant of osteochondroma that appears as a pinkish nodule under the free end of the nail plate. Some argue that subungual exostoses are better regarded as reactional osseous outgrowths rather than true tumors
A firm, flesh-colored nodule emanating from the distal subungual area of a great toenail in a young person is most characteristic. A subungual fibroma may look very similar. Diagnosis is made by X-ray.
Surgical removal of the bony exostosis should be performed.
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