Dermatology-IRCCS Policlinico di Sant'Orsola-Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Department of Dermatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
J Cutan Pathol. 2022 Feb;49(2):147-152. doi: 10.1111/cup.14119. Epub 2021 Aug 30.
Onychopapilloma is a benign tumor of the distal nail matrix and proximal nail bed with heterogeneous clinical presentations. It poses a diagnostic challenge because it could mimic subungual malignancies and inflammatory conditions. Clinical, onychoscopic, and histopathological clues play critical roles in diagnosis.
We performed a retrospective chart review of onychopapilloma cases collected over 10 years, and characterized the clinical, onychoscopic, and histopathological features of onychopapilloma at an academic institution.
We obtained 17 biopsy-confirmed cases of onychopapilloma. Among our cases, we found manifestation of onychopapilloma as longitudinal erythronychia, longitudinal leukonychia, yellow-brown chromonychia, and longitudinal melanonychia. Long longitudinal or short splinter hemorrhages may be present. Distal fissuring with V-shaped notch, subungual keratotic mass, and onycholysis are other discernable features. Histopathological features include papillomatosis, epidermal hyperplasia, acanthosis of the distal nail bed, premature keratinization, matrix metaplasia, hyperkeratosis, and splinter hemorrhages; histopathological signs of malignancy were not observed in any of our cases.
Onychopapilloma has polymorphic clinical and morphological features. Onychoscopic and histopathological studies are important to help exclude malignant mimickers. Consider onychopapilloma in the differential diagnoses of a monodactylous longitudinal streak in the nail, especially on the left thumb of an adult female.
甲乳头瘤是一种起源于甲母质和近端甲床的良性肿瘤，临床表现具有异质性。由于其可能模仿甲下恶性肿瘤和炎症性疾病，因此诊断具有挑战性。临床、甲下镜和组织病理学线索在诊断中起着关键作用。
我们对 10 多年来收集的甲乳头瘤病例进行了回顾性图表分析，并在学术机构中对甲乳头瘤的临床、甲下镜和组织病理学特征进行了特征描述。
我们获得了 17 例经活检证实的甲乳头瘤病例。在我们的病例中，我们发现甲乳头瘤的表现为纵向红甲、纵向白甲、黄棕色甲色素沉着和纵向黑甲。可能存在长纵向或短裂片状出血。远端裂隙伴 V 形切迹、甲下角化性肿块和甲分离是其他可识别的特征。组织病理学特征包括乳头瘤病、表皮增生、远端甲床棘皮症、过早角化、基质化生、角化过度和裂片状出血；我们的病例中均未观察到恶性肿瘤的组织病理学迹象。
甲乳头瘤具有多种形态的临床和形态学特征。甲下镜和组织病理学研究对于排除恶性类似物很重要。在甲的单发性纵向条纹的鉴别诊断中，尤其是在成年女性的左手拇指中，应考虑甲乳头瘤。
