J Am Podiatr Med Assoc. 2021 Dec 15;111(6). doi: 10.7547/20-209.
Subungual exostosis (SE) is a benign, relatively uncommon bony growth underneath the nails of the distal phalanx of toes or fingers, with a majority on the toes. Clinically, it has two subvariants-protruded and nonprotruded growths from nail plates-which are treated differently. In this article, we report a case of protruded SE in a teenager with illustrative surgical excision. A 15-year-old boy presented with a painful growth on his right great toe of 6 months' duration. Physical examination revealed a 1-cm-diameter, solid, erythematous, rough, irregular growth penetrating through the skin along the dorsolateral nail bed of the right hallux with deformity of the lateral nail plate. Radiographs showed an elevated mass over the distal phalanx of the right lateral hallux. The mass was surgically excised and histopathologic examination confirmed the diagnosis of SE. The patient had no relapse or recurrence at follow-ups of 6 and 18 months. Subungual exostosis is a relatively uncommon bony growth in the toes. Radiography is favored for the diagnosis. Complete surgical excision is the optimal treatment, with rare recurrence. It needs to be differentiated from other bony lesions, including bizarre parosteal osteochondromatous proliferation, myositis ossificans, fibro-osseous pseudotumor, osteochondroma, and enchondroma.
甲下外生骨疣（SE）是一种良性、相对少见的位于脚趾或手指远节指骨甲下的骨性生长物，多数发生在脚趾上。临床上，它有两种亚型——从甲床突出和不突出的生长物——其治疗方法不同。本文报告了一例青少年患者的突出型 SE，并附有说明性的手术切除。一名 15 岁男孩因右大脚趾疼痛性生长物就诊，病程 6 个月。体格检查显示右大脚趾背外侧甲床沿趾侧有一 1cm 直径、实性、红斑、粗糙、不规则的生长物，穿透皮肤，伴有外侧甲板畸形。X 线片显示右外侧近节趾骨有一隆起的肿块。肿块被手术切除，组织病理学检查证实了 SE 的诊断。患者在 6 个月和 18 个月的随访中均无复发或复发。甲下外生骨疣是一种相对少见的脚趾骨生长物。放射学检查有利于诊断。完全手术切除是最佳治疗方法，很少复发。需要与其他骨病变相鉴别，包括奇异型骨旁骨软骨瘤病、骨化性肌炎、纤维-骨性假瘤、软骨瘤和软骨母细胞瘤。
