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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia del Piede 2011 December;35(3):113-8
Subungual exostoses: a rare and often unrecognized pathology
Cerlon R., Balboni E., Versiglia F., Morino L., Crova M.
U.O.S Chirurgia del Piede, II Clinica Ortopedica Universitaria CTO, Torino
Subungueal exostosis is a bone benign lesion that grows in subungueal site or near the nail. Clinical picture needs careful differential diagnosis with subungueal verruca, subungueal melanoma and malignant tumor of distal phalanx; nevertheless the most important differential diagnosis is with ingrowing nail, because of similar clinical picture. From January 2004 to May 2009, three patients (2 women and 1 man), with diagnosis of subungueal exostosis of big toe, have been treated at the Unit of Foot Surgery of the Department of Orthopedics at the Trauma Hospital in Turin, Italy. We visited all the patient after several treatments in other hospitals with diagnosis of recurring ingrowing nail. No previous radiographic assessment was present. We suggest a regular radiographic exam of the big toe when there is a subungueal pathology with recurring phlogosis and pain in young people. Subungueal exostosis is a rare pathology and the clinical picture is misleading, because it is easier to find local phlogistic reaction than clinical signs of a occupying space lesion and this is the reason for the wrong diagnosis of our patients.