Onychomatricoma: a tumor unknown to dermatologists

Abstract

A sixty-one year old white female was referred to the Dermatology Department to treat an ingrown nail in the inner corner of the left hallux. Examination of the entire nail unit showed the presence of xanthonychia in the outer corner besides thickening and increase in the transverse curvature of the nail plate. Dermoscopy and nuclear magnetic resonance of the free edge of the nail plate detected characteristic signs of onychomatricoma, a diagnosis that was later confirmed by anatomopathological exam.

Onychomatricoma: A Rare Nail Tumor with an Unusual Clinical Presentation

“…Clinically, onychomatricoma presents with xanthonychia, nail thickening, splinter hemorrhages, longitudinal and transverse overcurvature of the nail plate, and woodworm cavities at the distal margin of the nail plate. Other clinical presentations include longitudinal melanonychia, nail dystrophy, subungual hematoma, as well as nodular and dorsal pterygium [3]. Avulsion of the nail plate typically reveals a filamentous tumor with multiple tufted, filiform projections arising from the nail matrix projecting onto the nail plate.…”

Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants

“…Finally, OM has also been reported in the literature to present as ingrown nail [2] or subungual hematoma [32] or to coexist with a glomus tumor [33]. …”

“…Although first described by Baran and Kint [1] in 1992, there have been approximately 200 cases reported in the literature so far. Patients are usually females around their fifties who are finally diagnosed years after the tumor's original appearance as the latter is slow-growing and painless, leading to progressive nail dystrophy [2]. OM typically presents with the clinical tetrad of xanthonychia, pachyonychia, proximal splinter hemorrhages and increased transverse overcurvature of the nail plate [3].…”

Onychomatrichoma

“…It characterized by digitiform projections from the matrix that also leads to changes of the nail plate. Women in the 5 th decade of life are most commonly affected [1]. Clinically, one or multiple fingernails may contain the tumor simultaneously.…”

“…Clinically, one or multiple fingernails may contain the tumor simultaneously. Physical exam findings include xanthonychia, ungula hyperkeratosis, splinter hemorrhages and longitudinal transverse over-curvature of the nail plate [1][2][3]. A frontal view of the nail typically reveals multiple holes in the thickened free margin.…”