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.
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- Onychomatrixoma: filamentous tufted tumour in the matrix of a funnel-shaped nail: a new entity (report of three cases).Br J Dermatol. 1992; 126: 510-515
- Onychomatricoma.Dermatol Surg. 1995; 11: 984-987
- Onychomycosis and onychomatricoma.Skin Appendage Disord. 2015; 1: 209-212
- Onychomatricoma: a rare tumor of nail matrix.Ann Dermatol. 2016; 28: 237-241
- Utilization of Mohs micrographic surgery in a patient with onychomatricoma.Dermatol Surg. 2015; 41: 753-755
- A tumor hidden beneath the nail plate: report of a rare case of onychomatricoma with three-dimensional histopathological analysis and immunohistochemical study.Indian J Dermatol. 2015; 60: 212
- Onychomatricoma masquerading as candida onychomycosis and paronychia.Acta Dermatovenerol Croat. 2013; 21: 198-201
- Onychomatricoma: an infrequent nail tumor.Indian J Dermatol Venereol Leprol. 2012; 78: 382-383
- Onychomatricoma: a case report with literature review.Foot Ankle Spec. 2012; 5: 41-44
- Onychomatricoma: clinical and sonographic findings.Arch Dermatol. 2009; 145: 1461-1462
- A rare tumour of the nail apparatus: onychomatricoma.J Eur Acad Dermatol Venereol. 2008; 22: 1127-1128
- Giant onychomatricoma: report of two cases with rare clinical presentation.Int J Dermatol. 2007; 46: 634-636
- Onychomatricoma.J Hand Surg Br. 1999; 24: 120-121
- Onychomatricoma with misleading features.Acta Derm Venereol. 2000; 80: 370-372
- Onychomatricoma: an unusual case of ungual pathology. Case report and review of the literature.J Plast Reconstr Aesthet Surg. 2010; 63: 54-57
- Pigmented onychomatricoma: a rare pigmented nail unit tumor presenting as longitudinal melanonychia that has the potential for misdiagnosis as melanoma.J Foot Ankle Surg. 2015; 54: 723-725
- Onychomatricoma: first description in a child.Pediatr Dermatol. 2007; 24: 46-48
- Fungal nail infections (onychomycosis): a never-ending story?.PLoS Pathog. 2014; 10: e1004105
- Nail clipping diagnosis of onychomatricoma.Arch Dermatol. 2011; 147: 1117-1118
- Onychomatricome: a nouveaux cas: interet de la resonance magnetique nucleaire.Ann Dermatol Venereol. 1994; 121: S145
- Onychomatricoma: clinical and histopathologic findings in 12 cases.J Am Acad Dermatol. 1998; 39: 560-564
- Onychomatricoma: new clinical and histological features. A review of 19 tumors.Am J Dermatopathol. 2010; 32: 1-8
- Onychomatricoma: an often misdiagnosed tumor of the nails.Cutis. 2015; 96: 121-124
- Onychomatricoma: genome-wide analyses of a rare nail matrix tumor.J Am Acad Dermatol. 2011; 64: 573-578
Published online: May 27, 2017
Financial Disclosure: None reported.
Conflict of Interest: None reported.
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.