Subungual exostosis

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Subungual exostoses are bony projections which arise from the dorsal surface of the distal phalanx, most commonly of the hallux.[1]


They tend to be painful due to the pressure applied to the nail bed and plate. They can involve destruction of the nail bed.[2] These lesions are not true osteochondromas, rather it is a reactive cartilage metaplasia. The reason it occurs on the dorsal aspect is because the periosteum is loose dorsally but very tightly adherent volarly.[3]

Subungal malignant melanomas can also occur in canines.

They are distinct from subungual osteochondroma.[4]


Surgical excision is common and is a very effective mode of treatment.

See also[edit]


  1. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0. 
  2. ^ Suga H, Mukouda M (2005). "Subungual exostosis: a review of 16 cases focusing on postoperative deformity of the nail". Annals of Plastic Surgery. 55 (3): 272–5. doi:10.1097/ PMID 16106166. 
  3. ^ Murphey MD, Choi JJ, Kransdorf MJ, et al: Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics 20:1407-1434, 2000
  4. ^ Lee SK, Jung MS, Lee YH, Gong HS, Kim JK, Baek GH (2007). "Two distinctive subungual pathologies: subungual exostosis and subungual osteochondroma". Foot & ankle international / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society. 28 (5): 595–601. doi:10.3113/FAI.2007.0595. PMID 17559767. 

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