Subungual Nodules
definition
There are various types of tumors that can form under the nail and negatively affect the nail matrix or bed, the surrounding epidermis, the dermis, the subcutaneous tissue, the osteochondral structures, as well as the entire nail. Some of these tumors are benign, while others may be malignant.
- Specialized Diagnosis with Dermoscopy
• Personalized Management with selection of the optimal therapeutic approach
• Advanced treatment methods
• Timely Management of Malignant Lesions
Benign Tumors/Lesions
Pyogenic Granuloma
This is a reddish bump with a smooth surface that often appears moist. It is soft in texture and bleeds easily. It usually occurs after trauma to the nail.
Köenen's Nodules
These develop slowly and are skin-colored. They form around the nail.
Subungual Glomus Tumor
Located under the nail and may cause sharp pain, which worsens in cold conditions
Onychopapilloma
Appears as a stripe extending from the cuticle to the free edge of the nail. It may be pink, brown, or whitish. Typically, a small yellowish nodule develops near the cuticle, under the nail
Onychomatricoma
Manifests as a linear yellow band with thickening in the area of the nail, which may also become curved
Keratoacanthoma
One of the fastest-growing tumors. Appears under the nail and may cause severe damage, even to the bone of the finger, within a few weeks or months
Subungual Warts
Cause nail detachment and intense pain or discomfort
Subungual Exostoses
These are benign bony growths that develop under the nail, usually causing pain and discomfort. A hard, rough mass may be seen protruding from the nail surface, leading to nail detachment or deformation
Myxoid Pseudocysts
Develop under the nail and are filled with a fluid or gelatinous substance. They are usually painless but may lead to nail detachment, especially if they grow or become infected. Their appearance may affect the aesthetic of the nail
Fibromas
Fibromas are benign tumors composed of fibrous tissue. In the area under the nail, they may cause local swelling and discomfort, and in some cases their growth may lead to nail deformation
Chondroma
Chondromas are benign tumors composed of cartilage tissue. When they appear under the nail, they may cause pain and limited mobility, and in advanced stages may lead to deformation of the nail or finger
Malignant Tumors
Melanoma (Longitudinal Melanonychia)
One of the most aggressive types of skin cancer, which may manifest as a longitudinal melanonychia under the nail. It is characterized by rapid spread to surrounding skin and requires immediate surgical intervention. In cases of metastasis, chemotherapy may be needed to limit its spread
Bowen’s Disease
Appears as an ulcerated lesion under the nail and is often accompanied by bleeding. Although initially benign, it can develop into squamous cell carcinoma of the skin if not properly treated
Squamous Cell Carcinoma
A gradually progressing form of cancer that can affect the skin around the nail and slowly spread to deeper tissues. Although it progresses slowly, delayed diagnosis may lead to metastases, requiring surgery or other therapeutic approaches
Hemangioendothelioma
A benign tumor that develops from blood vessels and may appear under the nail. Although it usually does not cause pain, its growth may cause local swelling and sometimes bleeding, necessitating monitoring and occasionally treatment
Therapeutic Management
An experienced dermatologist can properly diagnose the condition and suggest the optimal treatment, depending on the origin and aggressiveness of the lesion. Treatment options include surgical removal, laser use, with surgery being the most common option.
Lesions with a benign clinical appearance are removed if symptomatic, while asymptomatic lesions are regularly monitored with clinical examination, photographs, and dermoscopy. The frequency of examinations is adjusted according to the lesion’s needs.