title: Dystrophy of the Great Toenail by Subungual Exostosis and Hyperostosis: Three Case Reports with Different Clinical Presentations.
abstract: Subungual exostoses and hyperostoses of the great toenail are a differential diagnosis of nail tumors. We present 3 cases of subungual exostosis/hyperostosis with secondary nail dystrophy: a 36- and a 37-year-old woman as well as an 8-year-old boy. Two of the 3 patients suffered from pain. The 2 female patients presented with the classic dorsolateral firm protrusion, while the child presented with bilateral nail dystrophy with lateral wall hypertrophy. In this later case, a bony ridge was identified, which is an unusual subungual, nonprotruding type of exostosis. The hypertrophic lateral walls were removed by the Vandenbos technique. In the 2 former cases, complete excision of the bony lesions was performed with a proximal block. Healing by second intention was uneventful.
authors.affiliation: Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.affiliation: Nail Disease Centre, Cannes, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Baran
authors.affiliation: Institute of Pathology 'Georg Schmorl', Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Schönlebe
keywords: Bone; Hyperostosis; Malalignment of the great toenail; Nail surgery; Nail tumors; Pain; Subungual exostosis