Abstract
Onychomatricoma is a rare benign neoplasm of the nail matrix first described by Baran
and Kint in 1992. Fewer than 80 cases of onychomatricoma have been described in the
literature, 15 of which were initially misdiagnosed and treated as onychomycosis.
We present the case of a 66-year-old male with thickening and linear xanthonychia
of the hallux nail plate secondary to an onychomatricoma misdiagnosed as onychomycosis.
Following biopsy for histopathologic analysis, the lesion and proximal nail matrix
were surgically excised. At 12 months post-excision, the patient remains asymptomatic
without evidence of recurrence. The purpose of the present case report is to make
foot and ankle surgeons more cognizant of the pathology, highlight the nonspecific
clinical and radiologic findings, and emphasize the importance of interdisciplinary
communication for an accurate clinicopathologic correlation and diagnosis of the lesion.
Although rare, onychomatricoma should be considered in the differential diagnosis
for patients presenting with onychomycosis failing to respond to antimycologic treatment.
The clinical index of suspicion for onychomatricoma should increase when only a singular
dystrophic nail is involved. Following diagnostic confirmation by histopathology,
complete surgical excision is the treatment of choice.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: May 27, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
