J. S. W. Yun, A. Howard, S. Prakash, J. Kern
Background: Onychopapilloma is a benign neoplasm of the nail bed and distal matrix, where the term has only been introduced in 2000 (2). To date, only 19 case reports/ series of this condition have been published, and none in Australia.
Methods: We have reviewed the published literature and retrospectively analysed the clinical and pathological fea- tures of 50 patients who had clinical diagnosis of ony- chopapilloma diagnosed within the last 5 years in a specialised nail clinic.
Results: A total of 50 cases of onychopapilloma were reviewed, of which 15 patients were managed conserva- tively, and 24 patients were managed surgically. Thumb was the most frequently affected digit. The most affected digit was the thumb (n = 28, 56%) and the most common clinical feature of onychopapilloma was subungual hyperk- eratotic mass (n = 29, 58%); followed by distal ﬁssures (n = 23, 46%), erythronychia (n = 21, 42%) and longitudi- nal ridge (n = 21, 42%). The clinical ﬁndings were consis- tent with pathological features including papillomatosis, nail matrix metaplasia and subungual hyperkeratosis.
Conclusion: To date, this is the ﬁrst case series of ony- chopapilloma in Australia. Onychopapilloma has a wide variation in presentation, but the presence of subungual hyperkeratotic mass is highly suggestive of the diagnosis. Surgical management is possible where the onychopapil- loma causes pain, inconvenience for patient or to rule out malignancy, but biopsy to achieve the diagnosis may be avoided in many cases by careful clinical observation with dermoscopy or with non-invasive transversal nail clippings.
1. Baran R, Perrin C. Longitudinal erythronychia with distal subun- gual keratosis: onychopapilloma of the nail bed and Bowen’s dis- ease. Br J Dermatol. 2000;143(1):132–5.