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Subungual exostosis

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Painful toe.

Patient Data

Age: 14 years
Gender: Male

Right foot

x-ray

Sharply marginated dorsolateral exostosis at the 3rd distal toe phalanx.

Case Discussion

Subungual exostoses are benign osteocartilaginous tumors. They mostly affect the big toe and are predominantly found in children and young adolescents. They probably result from metaplasia in mechanical irritations or diseases of the nailbed. Their precise etiology is unknown 1.

The lesion seems to be distinct from osteochondroma 2 and also has to be differentiated from Nora lesion (BPOP) and aggressive lesions.

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