Ann Dermatol.  2020 Feb;32(1):74-76. 10.5021/ad.2020.32.1.74.

A Rare Case of Onychopapilloma Presenting as a Longitudinal Erythronychia

• Park HJ
• Park HJ

• KMID: 2467205
• DOI: http://doi.org/10.5021/ad.2020.32.1.74

Abstract

Onychopapilloma is a rare benign neoplasm of the nail bed and the distal matrix. It is the most common cause of monodactylous localized longitudinal erythronychia. Splinter hemorrhage, onycholysis or distal splitting are usually accompanied due to the subungual keratotic growth located in the corresponding linear streak. A 50-year-old female was referred for the evaluation of 1-mm width of erythematous band on the left thumbnail. Distal onycholysis and splinter hemorrhages were seen along the streak with a thread-like horny papule beneath the edge of the nail plate. On histopathologic examination, papillomatosis and acanthosis were observed in the distal nail bed epithelium. The upper layers of the nail bed epithelium showed matrix metaplasia. The nail plate specimen revealed subungual hyperkeratosis with focal hemorrhage. The histopathological findings confirmed the clinical diagnosis of onychopapilloma. Herein, we report a rare case of onychopapilloma presenting as a longitudinal erythronychia.

Keyword

Nails; Neoplasm; Onychopapilloma

MeSH Terms

Diagnosis
Epithelium
Female
Hemorrhage
Humans
Metaplasia
Middle Aged
Onycholysis
Papilloma

Figure

• 

  Fig. 1 (A) Longitudinal erythematous streak on the left thumbnail (red arrow), distal onycholysis (yellow arrow) and splinter hemorrhages (green arrow) observed along the linear band (top view). (B) A solitary hyperkeratotic warty or thread-like subungual papule on the left thumb tip (black arrows) (front view).

• 

  Fig. 2 (A) Longitudinal biopsy specimen of epithelium from the normal nail matrix to the papillomatous nail bed (H&E, scanning view). (B) Nail bed epithelial cells with abundant eosinophilic cytoplasm indicating matrix metaplasia (H&E, ×200). (C) Papillomatosis and acanthosis with thickened fibrovascular stroma in the nail bed (H&E, ×100). (D) Subungual layered hyperkeratosis with focal hemorrhage (H&E, ×100).

Reference

1. Delvaux C, Richert B, Lecerf P, André J. Onychopapillomas: a 68-case series to determine best surgical procedure and histologic sectioning. J Eur Acad Dermatol Venereol. 2018; 32:2025–2030.

2. Tosti A, Schneider SL, Ramirez-Quizon MN, Zaiac M, Miteva M. Clinical, dermoscopic, and pathologic features of onychopapilloma: a review of 47 cases. J Am Acad Dermatol. 2016; 74:521–526.

3. Baran R, Perrin C. Longitudinal erythronychia with distal subungual keratosis: onychopapilloma of the nail bed and Bowen's disease. Br J Dermatol. 2000; 143:132–135.

4. Halteh P, Magro C, Scher RK, Lipner SR. Onychopapilloma presenting as leukonychia: case report and review of the literature. Skin Appendage Disord. 2017; 2:89–91.

5. Sarkissian L, Fattouh K, Kanitakis J, Villani AP. DeRmpath & clinic: onychopapilloma. Eur J Dermatol. 2017; 27:336–337.

6. Min J, Nam JH, Chae SW, Lee GY, Kim WS. Case of onychopapilloma presenting as longitudinal melanonychia. Dermatol Sin. 2017; 35:102–103.

7. Kim M, Sun EY, Jung HY, Cho BK, Park HJ. Onychopapilloma: a report of three cases presenting with various longitudinal chromonychia. Ann Dermatol. 2016; 28:655–657.

8. Criscione V, Telang G, Jellinek NJ. Onychopapilloma presenting as longitudinal leukonychia. J Am Acad Dermatol. 2010; 63:541–542.

9. Ito T, Uchi H, Yamada Y, Oda Y, Furue M. Onychopapilloma manifesting longitudinal melanonychia: a mimic of subungual malignancy. J Dermatol. 2015; 42:1199–1201.

10. Jellinek NJ. Longitudinal erythronychia: suggestions for evaluation and management. J Am Acad Dermatol. 2011; 64:167.e1–167.e11.

11. de Berker DA, Perrin C, Baran R. Localized longitudinal erythronychia: diagnostic significance and physical explanation. Arch Dermatol. 2004; 140:1253–1257.

12. Beggs S, Butala N, Heymann WR, Rubin AI. Onychopapilloma Presenting as longitudinal erythronychia in an adolescent. Pediatr Dermatol. 2015; 32:e173–e174.

13. Cohen PR. Longitudinal erythronychia: individual or multiple linear red bands of the nail plate: a review of clinical features and associated conditions. Am J Clin Dermatol. 2011; 12:217–231.

14. Lipner SR, Scher RK. Evaluation of nail lines: color and shape hold clues. Cleve Clin J Med. 2016; 83:385–391.

15. Dalle S, Depape L, Phan A, Balme B, Ronger-Savle S, Thomas L. Squamous cell carcinoma of the nail apparatus: clinicopathological study of 35 cases. Br J Dermatol. 2007; 156:871–874.

16. Cogrel O, Beylot-Barry M, Doutre MS. [Subungual squamous cell carcinoma revealed by longitudinal erythronychia]. Ann Dermatol Venereol. 2008; 135:883–885. French.

17. Jellinek NJ, Lipner SR. Longitudinal Erythronychia: Retrospective Single-Center Study Evaluating Differential Diagnosis and the Likelihood of Malignancy. Dermatol Surg. 2016; 42:310–319.