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A subungual exostosis is a benign lesion described as a variant of an osteochondroma. It mostly affects the great toe, and it can be confused with an osteochondroma and a Nora’s lesion. The curative treatment for a subungual exostosis is complete excision, and the cartilaginous cap must be totally resected to prevent a possible recurrence. In this article, we present findings regarding a large and painful lesion on the dorsomedial aspect of the great toe of a patient. (J Am Podiatr Med Assoc 100(4): 296–298, 2010)