Conway Jade, Magro Cynthia M, Lipner Shari R
New York Medical College, Valhalla, NY, USA.
Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA.
Case Rep Dermatol. 2024 Mar 28;16(1):88-93. doi: 10.1159/000538087. eCollection 2024 Jan-Dec.
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.
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.
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.
甲乳头状瘤最常见的表现为纵向红甲，但由于临床表现多样，某些病例的诊断可能具有挑战性。大多数甲乳头状瘤患者并未报告相关疼痛，而是更常报告功能障碍。
我们报告一例74岁女性，有5年右拇指甲劈裂和翘起病史，伴有指甲敏感和间歇性搏动性疼痛。临床检查发现一条小于1毫米的红线，伴有远端甲剥离。进行的洛夫试验和用冰袋进行的冷试验均为阴性。右手拇指X线检查未见侵蚀或外生骨疣。进行了指甲活检，皮肤病理学检查结果符合甲乳头状瘤伴创伤性神经瘤。
我们报告一例甲乳头状瘤伴创伤性神经瘤。甲下神经瘤极为罕见，此前未曾与甲乳头状瘤相关联。我们的病例支持扩大对疼痛性指甲的鉴别诊断范围，并证明了通过活检和组织病理学进行诊断确认的重要性。
