Pleomorphic onychomatricoma

Fernández-Flores, Ángel; Barja, Juan

doi:10.1111/cup.12363

Cited by 10 publications

(14 citation statements)

References 9 publications

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“…The superficial layer is loose and wavy and contains mast cells, while the deeper layer is eosinophilic, hypocellular and densely fibrocollagenous. Rarely, pleomorphic and hyperchromatic, uninucleated and multinucleated giant cells are also present [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, superficial acral fibromyxoma stains with CD99, perineurioma stains with EMA, and neurofibroma stains with S100. However, none of these tumors contain the epithelial-lined, spiky digitations of onychomatricoma that are best visualized on hematoxylin and eosin-stained sections [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Acral fibrokeratoma may mimic proximal nail fold-derived onychomatricoma; however, acral fibrokeratoma is seldom located under the nail plate and it lacks the filamentous strands of onychomatricoma [1]. Pleomorphic fibroma, similar to onychomatricoma, may show pleomorphic and hyperchromatic, and uninucleated and multinucleated giant cells; however, pleomorphic fibroma lacks two of onychomatricoma's characteristic features: epithelial invaginations and two distinct (wavy superficially and collagenous deep) fibrous layers [8,9]. Another nail matrix tumor, onychocytic matricoma, can clinically present similarly to onychomatricoma as longitudinal nail plate thickening; however, onychocytic matricoma shows endokeratinization, lacks a stromal component, and lacks the undulating, keratogenous zone-like epithelium characteristic of an onychomatricoma [3].…”

Section: Discussionmentioning

confidence: 99%

“…Once the tumor has been exposed, after avulsion of the nail plate, it must be completely removed. Recurrence is uncommon, yet recurrent onychomatricoma has previously been observed [9].…”

Section: Discussionmentioning

confidence: 99%

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Onychomatricoma Presenting as a Dystrophic Right Great Toenail: Case Report and Review

Romero¹,

Park²,

Shoaee³

et al. 2020

Cureus

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Onychomatricoma is a rare, benign nail matrix tumor. It most frequently occurs on one of the first three fingers of the dominant hand or the big toe in middle-aged women. Our patient presented with a 10-year history of a progressive thickening of her right great toenail; it bled easily and was intermittently painful. She had experienced trauma to the nail prior to the onset of the dystrophy. MRI primarily showed inflammation localized to the nail bed without bony extension. Excisional biopsy, which included both the nail plate and matrix, established the diagnosis of onychomatricoma originating from the ventral nail matrix (lunula). Nail trauma or fungal infection may have a causative role in the pathogenesis of onychomatricoma. The nail plate can show splitting, increased curvature, or ridging; it can also present with yellow, red or brown, linear, pigmented bands. The clinical differential diagnosis of onychomatricoma includes fibrokeratoma, melanonychia, onychomycosis, periungual fibroma, and squamous cell carcinoma. Dermoscopic imaging shows parallel lesion edges and splinter hemorrhages; these dermoscopic features support the diagnosis of onychomatricoma over squamous cell carcinoma. Imaging such as ultrasound or MRI may suggest the diagnosis. Biopsy of the tumor is necessary to establish the diagnosis; the tumor may derive either from the ventral nail matrix (lunula) or from the ventral surface of the proximal nail fold. Histologic features vary depending not only on tumor origin but also on tissue orientation. Proximally, there is a fibroepithelial tumor consisting of fibrous stalk pierced by epithelial invaginations; the epithelium shows matrical differentiation containing basal and prekeratogenous cells. Distally, the tumor pierces the nail plate as glove-finger digitations; these digitations appear as discrete villi in the nail plate or show their negative image as multiple empty channels that have been described as "worm holes". The channels may be epithelial lined and contain serous fluid. It is important to obtain an adequate biopsy specimen; the distinctive fibroepithelial histology might be inapparent in partial specimens lacking the epithelial invaginations. Immunohistochemical staining can distinguish onychomatricoma from tumors that can mimic its pathologic changes: fibromyxoma, neurofibroma, and perineurioma. Complete surgical excision is generally curative.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Once the tumor has been exposed, after avulsion of the nail plate, it must be completely removed. Recurrence is uncommon, yet recurrent onychomatricoma has previously been observed [9].…”

Section: Discussionmentioning

confidence: 99%

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Onychomatricoma Presenting as a Dystrophic Right Great Toenail: Case Report and Review

Romero¹,

Park²,

Shoaee³

et al. 2020

Cureus

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“…Stewart et al [35] reported an OM with prominent myxoid stroma associated with the fibrous component. Perrin et al [5] and Fernandez-Flores and Barja-Lopez [36] described a pleomorphic variant with wreath-like multinucleated cells along with zonal distribution of mast cells in the superficial stromal layer and membranous expression of CD34.…”

Section: Discussionmentioning

confidence: 99%

Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants

Prevezas

Triantafyllopoulou

Belyayeva

et al. 2015

Skin Appendage Disord

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Onychomatricoma is a rare benign fibroepithelial filamentous tumor originating from the nail matrix. It typically presents with the clinical tetrad of xanthonychia, pachyonychia, proximal splinter hemorrhages and increased transverse overcurvature of the nail plate. The giant variant can easily confuse the clinician due to its extensive nail dystrophy that can mask the characteristic features of this tumor. Benign (fibrokeratoma, ungual fibroma, onycholytic matricoma) and malignant entities (Bowen's disease, squamous cell carcinoma, onycholytic carcinoma) are mimics of the disease. Nail surgery can facilitate the diagnosis, which should always be confirmed by histology, as rare variants do exist.

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Pathology of the Nail Unit

Ruben¹

2021

Dermatologic Clinics

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Pleomorphic onychomatricoma

Abstract: Figures 1 and 2 are depicted on the journal cover.

Cited by 10 publications

References 9 publications

Onychomatricoma Presenting as a Dystrophic Right Great Toenail: Case Report and Review

Onychomatricoma Presenting as a Dystrophic Right Great Toenail: Case Report and Review

Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants

Pathology of the Nail Unit

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