Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with Neuroma

Introduction: Onychopapilloma most commonly presents as longitudinal erythronychia, but diagnosis may be challenging in some cases due to varied clinical presentations. Most patients with onychopapillomas do not report associated pain but instead more commonly report functional interference. Case Re...

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Main Authors: Jade Conway, Cynthia M. Magro, Shari R. Lipner
Format: Article
Language:English
Published: Karger Publishers 2024-03-01
Series:Case Reports in Dermatology
Subjects:
Online Access:https://beta.karger.com/Article/FullText/538087
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author Jade Conway
Cynthia M. Magro
Shari R. Lipner
author_facet Jade Conway
Cynthia M. Magro
Shari R. Lipner
author_sort Jade Conway
collection DOAJ
description Introduction: Onychopapilloma most commonly presents as longitudinal erythronychia, but diagnosis may be challenging in some cases due to varied clinical presentations. Most patients with onychopapillomas do not report associated pain but instead more commonly report functional interference. Case Report: We present a case of a 74-year-old female with a 5-year history of splitting and lifting of the right thumbnail, accompanied by nail sensitivity and intermittent painful throbbing. Clinical examination was significant for a less than 1 mm red line with distal onycholysis. Love’s test and a cold test performed with ice pack were negative. X-ray of the right thumb was negative for erosion or exostosis. Nail biopsy was performed, and dermatopathology was consistent with onychopapilloma with a concomitant traumatic neuroma. Conclusion: We report a case of onychopapilloma with a concomitant traumatic neuroma. Subungual neuromas are extremely rare and have not previously been associated with onychopapilloma. Our case supports the expansion of the differential diagnosis for a painful nail and demonstrates the importance of diagnostic confirmation with biopsy and histopathology.
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spelling doaj.art-ec077e158d9d496eb3a5f3f2e498f1d72024-04-25T06:31:59ZengKarger PublishersCase Reports in Dermatology1662-65672024-03-01161889310.1159/000538087538087Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with NeuromaJade Conway0Cynthia M. Magro1Shari R. Lipner2New York Medical College, Valhalla, NY, USADepartment of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USADepartment of Dermatology, Weill Cornell Medicine, New York, NY, USAIntroduction: Onychopapilloma most commonly presents as longitudinal erythronychia, but diagnosis may be challenging in some cases due to varied clinical presentations. Most patients with onychopapillomas do not report associated pain but instead more commonly report functional interference. Case Report: We present a case of a 74-year-old female with a 5-year history of splitting and lifting of the right thumbnail, accompanied by nail sensitivity and intermittent painful throbbing. Clinical examination was significant for a less than 1 mm red line with distal onycholysis. Love’s test and a cold test performed with ice pack were negative. X-ray of the right thumb was negative for erosion or exostosis. Nail biopsy was performed, and dermatopathology was consistent with onychopapilloma with a concomitant traumatic neuroma. Conclusion: We report a case of onychopapilloma with a concomitant traumatic neuroma. Subungual neuromas are extremely rare and have not previously been associated with onychopapilloma. Our case supports the expansion of the differential diagnosis for a painful nail and demonstrates the importance of diagnostic confirmation with biopsy and histopathology.https://beta.karger.com/Article/FullText/538087onychopapillomaneuromanailpain
spellingShingle Jade Conway
Cynthia M. Magro
Shari R. Lipner
Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with Neuroma
Case Reports in Dermatology
onychopapilloma
neuroma
nail
pain
title Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with Neuroma
title_full Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with Neuroma
title_fullStr Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with Neuroma
title_full_unstemmed Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with Neuroma
title_short Expanding the Differential Diagnosis of the Painful Nail: A Case of an Onychopapilloma with Neuroma
title_sort expanding the differential diagnosis of the painful nail a case of an onychopapilloma with neuroma
topic onychopapilloma
neuroma
nail
pain
url https://beta.karger.com/Article/FullText/538087
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AT cynthiammagro expandingthedifferentialdiagnosisofthepainfulnailacaseofanonychopapillomawithneuroma
AT sharirlipner expandingthedifferentialdiagnosisofthepainfulnailacaseofanonychopapillomawithneuroma