Retronychia is a recently described disorder caused by ingrowth of the proximal nail plate into the proximal nail fold. It is suspected when there is persistent paronychia, particularly in the setting of trauma. This disease is probably underdiagnosed due to limited knowledge among dermatologists and the presence of incomplete clinical forms. Nail plate avulsion is the diagnostic and curative procedure of choice, despite reports of relapse.

A 64-year-old woman presented to our department with a 2-week history of a painful enlarging nodule on her scalp. Dermatologic examination of the scalp revealed a nodule with a central pore with serosanguineous discharge. DERMOSCOPIC APPEARANCEDermoscopic examination of the furuncular lesion using oil as an interface showed bubbles escaping from the central orifice, surrounded by dilated blood vessels and triangular black dots (Fig 1, Video 1). DERMOSCOPY OF DERMATOBIA HOMINIS LARVAThe larva was forced out by mechanical pressure and extracted using forceps. Dermoscopy of the third instar larva of Dermatobia hominis showed bird's feet-like breathing spiracles on the posterior end; 2 curved mouth hooks on the anterior portion where the oral opening is located; and rows of concentric black spines around the body corresponding to the triangular black dots seen by transparency in the scalp dermoscopy (Fig 2).

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Onychomatricoma is a rare and specific benign tumor of the nail complex, with uncertain etiology. The avulsion of the nail plate reveals cavitations and orifices in its proximal extremity. These are associated with villous tumor formations generating digitiform projections at the nail matrix – typical intraoperative findings. We report a rare case of onychomatricoma in which the nail bed was predominantly affected and show evidence of its clinical, intraoperative, and histopathological presentation. The various descriptions of the disease report that its origin is restricted to the nail matrix, leading to secondary changes in the nail plate.

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