• 1.

    Miller-Breslow A & Dorfman HD: Dupuytren's (subungual) exostosis. Am J Surg Pathol 12: 368, 1988.

  • 2.

    Li Y, Yue T & Han Y: Subungual exostosis. Chin Med Sci J 6: 169, 1991.

  • 3.

    DaCambra MP, Gupta SK & Ferri-de-Barros F: Subungual exostosis of the toes: a systematic review. Clin Orthop Relat Res 472: 1251, 2014.

  • 4.

    Başar H, Inanmaz ME & Başar B et al.: Protruded and nonprotruded subungual exostosis: differences in surgical approach. Indian J Orthop 48: 49, 2014.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 5.

    Warren KJ & Fairley JA: Stump the experts. Subungual exostosis. Dermatol Surg 24: 287, 1998.

  • 6.

    Suga H & Mukouda M: Subungual exostosis: a review of 16 cases focusing on postoperative deformity of the nail. Ann Plast Surg 55: 272, 2005.

  • 7.

    Storlazzi CT, Wozniak A & Panagopoulos I et al.: Rearrangement of the COL12A1 and COL4A5 genes in subungual exostosis: molecular cytogenetic delineation of the tumor-specific translocation t(X;6)(q13-14;q22). In J Cancer 118: 1972, 2006.

    • Search Google Scholar
    • Export Citation
  • 8.

    Zambrano E, Nosé V & Perez-Atayde AR et al.: Distinct chromosomal rearrangements in subungual (Dupuytren) exostosis and bizarre parosteal osteochondromatous proliferation (Nora lesion). Am J Surg Pathol 28: 1033, 2004.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    De Berker DA & Langtry J: Treatment of subungual exostoses by elective day case surgery. Br J Dermatol 140: 915, 1999.

  • 10.

    Davis DA & Cohen PR: Subungual exostosis: case report and review of the literature. Pediatr Dermatol 13: 212, 1996.

Subungual Exostosis on the Right Hallux

An Illustrative Case Report

Michael Tritto DPM, Gene Mirkin DPM, and Xingpei Hao MD, PhD
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Subungual exostosis (SE) is a benign, relatively uncommon bony growth underneath the nails of the distal phalanx of toes or fingers, with a majority on the toes. Clinically, it has two subvariants—protruded and nonprotruded growths from nail plates—which are treated differently. In this article, we report a case of protruded SE in a teenager with illustrative surgical excision. A 15-year-old boy presented with a painful growth on his right great toe of 6 months' duration. Physical examination revealed a 1-cm-diameter, solid, erythematous, rough, irregular growth penetrating through the skin along the dorsolateral nail bed of the right hallux with deformity of the lateral nail plate. Radiographs showed an elevated mass over the distal phalanx of the right lateral hallux. The mass was surgically excised and histopathologic examination confirmed the diagnosis of SE. The patient had no relapse or recurrence at follow-ups of 6 and 18 months. Subungual exostosis is a relatively uncommon bony growth in the toes. Radiography is favored for the diagnosis. Complete surgical excision is the optimal treatment, with rare recurrence. It needs to be differentiated from other bony lesions, including bizarre parosteal osteochondromatous proliferation, myositis ossificans, fibro-osseous pseudotumor, osteochondroma, and enchondroma.

Foot and Ankle Specialists of the Mid-Atlantic, LLC, Rockville, MD.

Corresponding author: Xingpei Hao, MD, PhD, 1600 Gude Dr, Ste 205, Rockville, MD 20852. (E-mail: xhao@footandankle-usa.com)