gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Onychomatricoma in the hand – three cases

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  • presenting/speaker Sarah Breiter - Universitätsklinikum Münster, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Sektion Handchirurgie, Münster, Germany
  • Martin Franz Langer - Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Germany
  • Simon Oeckenpöhler - Universitätsklinikum Münster, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Sektion Handchirurgie, Münster, Germany
  • Britta Wieskötter - Universitätsklinikum Münster, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Sektion Handchirurgie, Münster, Germany
  • Johanna Ueberberg - Universitätsklinikum Münster, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Sektion Handchirurgie, Münster, Germany

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1912

doi: 10.3205/19ifssh1173, urn:nbn:de:0183-19ifssh11730

Published: February 6, 2020

© 2020 Breiter et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objectives/Interrogation: Onychomatricoma is a rare benign fibroepithelial tumor developing from the nail matrix with striking clinical and histologic features. Onychomatricoma was first described in the literature in 1992 by Baran and Kint and less than 60 cases are described in the hand.

Methods: We report three case of onychomatricoma occurring in two female and one male with many years history of asymptomatic thickening of the fingernail. There was no history of preceding trauma. Nail clippings for mycology were negative on three occasions and hand radiographs showed no bony abnormality. Examination revealed diffuse thickening of the fingernail with increased transverse over-curvature. The nail was yellowish in color and there were longitudinal hollows visible as holes in the distal border. The nails of other fingers and toes were normal.

Results and Conclusions: Several clinical signs are striking enough to either make the diagnosis or at least to arouse suspicion:

  • Longitudinal thickening of a part of the nail plate that often spares a portion of the normal pinkish nail
  • Transverse and longitudinal overcurvature of the affected portion of the nail
  • Xanthonychia of the affected part of the affected nail
  • Longitudinal ridging that is sometimes quite prominent on the surface of the nail
  • Splinter hemorrhages that are mostly proximal but sometimes distal
  • Honeycomb cavities at the frontal margin of the thickened nail plate

Increased awareness of this entity is required among dermatologists, hand surgeons and histopathologists to ensure it is correctly diagnosed as there is a paucity of information in standard textbooks.