Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women
Subungual exostosis (SE) is a well-recognised benign proliferation of the distal phalanx most often seen in young adults and affecting the big toe. Possible triggers include previous trauma and chronic irritation or infection. We describe two atypical cases of SE in two young women presenting with p...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Dermatopathology |
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| Online Access: | https://www.mdpi.com/2296-3529/9/2/24 |
| _version_ | 1797488405336031232 |
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| author | Rosanna Fox Effie Katsarma Nick Tiffin Manuraj Singh |
| author_facet | Rosanna Fox Effie Katsarma Nick Tiffin Manuraj Singh |
| author_sort | Rosanna Fox |
| collection | DOAJ |
| description | Subungual exostosis (SE) is a well-recognised benign proliferation of the distal phalanx most often seen in young adults and affecting the big toe. Possible triggers include previous trauma and chronic irritation or infection. We describe two atypical cases of SE in two young women presenting with pyogenic granuloma-like lesions clinically. Diagnostic biopsies were performed to confirm the diagnosis and excluded amelanotic melanoma. However, histology unexpectedly revealed reactive myofibroblastic proliferations mimicking nodular fasciitis overlying the SE. Given the atypical clinical presentation, the diagnosis was initially missed or not considered in both patients. They highlight two important points; the first is that SEs may present with pyogenic granuloma-like lesions clinically and that histological analysis is then required to exclude malignancy, particularly amelanotic melanoma. Secondly, that the histology will show a reactive myofibroblastic proliferation and if the sample is relatively superficial and pathologists are not aware of this potential reaction pattern, the underlying diagnosis of SE may be missed. |
| first_indexed | 2024-03-10T00:01:42Z |
| format | Article |
| id | doaj.art-c2c68adfb7be471197e5eb4ead51aea9 |
| institution | Directory Open Access Journal |
| issn | 2296-3529 |
| language | English |
| last_indexed | 2024-03-10T00:01:42Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Dermatopathology |
| spelling | doaj.art-c2c68adfb7be471197e5eb4ead51aea92023-11-23T16:15:29ZengMDPI AGDermatopathology2296-35292022-06-019219620210.3390/dermatopathology9020024Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young WomenRosanna Fox0Effie Katsarma1Nick Tiffin2Manuraj Singh3Department of Acute Medicine, West Middlesex University Hospital, London TW7 6AF, UKDepartment of Plastic and Reconstructive Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UKDepartment of Dermatopathology, St George’s University Hospital, London SW17 0QT, UKDepartment of Dermatopathology, St George’s University Hospital, London SW17 0QT, UKSubungual exostosis (SE) is a well-recognised benign proliferation of the distal phalanx most often seen in young adults and affecting the big toe. Possible triggers include previous trauma and chronic irritation or infection. We describe two atypical cases of SE in two young women presenting with pyogenic granuloma-like lesions clinically. Diagnostic biopsies were performed to confirm the diagnosis and excluded amelanotic melanoma. However, histology unexpectedly revealed reactive myofibroblastic proliferations mimicking nodular fasciitis overlying the SE. Given the atypical clinical presentation, the diagnosis was initially missed or not considered in both patients. They highlight two important points; the first is that SEs may present with pyogenic granuloma-like lesions clinically and that histological analysis is then required to exclude malignancy, particularly amelanotic melanoma. Secondly, that the histology will show a reactive myofibroblastic proliferation and if the sample is relatively superficial and pathologists are not aware of this potential reaction pattern, the underlying diagnosis of SE may be missed.https://www.mdpi.com/2296-3529/9/2/24subungual exostosisreactive myofibroblastic proliferationpyogenic granulomanodular fasciitisamelanotic melanoma |
| spellingShingle | Rosanna Fox Effie Katsarma Nick Tiffin Manuraj Singh Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women Dermatopathology subungual exostosis reactive myofibroblastic proliferation pyogenic granuloma nodular fasciitis amelanotic melanoma |
| title | Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women |
| title_full | Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women |
| title_fullStr | Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women |
| title_full_unstemmed | Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women |
| title_short | Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women |
| title_sort | subungual exostosis presenting as a pyogenic granuloma like lesion with reactive myofibroblastic proliferation in two young women |
| topic | subungual exostosis reactive myofibroblastic proliferation pyogenic granuloma nodular fasciitis amelanotic melanoma |
| url | https://www.mdpi.com/2296-3529/9/2/24 |
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