Four Fattened Phalanges
Match the diagnosis to the photo by letter
a. Digital fibromyxoma
b. Dermatofibrosarcoma protuberans
c. Subungual exostosis
d. Onychomatricoma
For answers, see next issue; for discussion, go to www.mdedge.com/clinicianreviews/picture
Case presentations and photographs courtesy of Cutis. Copyright 2018 Frontline Medical Communications Inc.
Answers to November “Picture This” (Clinician Reviews. 2017;27[11]:39): 1c, 2a, 3b
1. A 54-year-old Colombian man presents with nail dystrophy of two years’ duration. Physical exam reveals longitudinally banded thickening of the lateral half of the nail plate with yellowish brown discoloration, transverse overcurvature of the nail, longitudinal white lines, and splinter hemorrhages.
Diagnosis: The lesion, diagnosed as onychomatricoma was surgically removed and sent for histopathologic study. Onychomatricoma is a subungual tumor characterized by banded or diffuse thickening, yellowish discoloration, splinter hemorrhages, and transverse overcurvature of the nail plate. Because the condition is not well known, it is often misdiagnosed.
,For more information, see “Onychomatricoma: An Often Misdiagnosed Tumor of the Nails.” Cutis. 2015;96(2):121-124.
