Post-traumatic ectopic nail-like structure

A man in his 50s presented with an asymptomatic nail-like structure of 3 mm diameter just below his left thumb nail (fig 1). While discussing his history, he reported trauma with a jigsaw (power tool, not puzzle) nearly three decades ago, when the moving blade injured the nail matrix zone. Although wound repair was successful, the patient developed unusual asymptomatic tissue growth at the site of the injury several months later. Ectopic nail (onychoheterotopia) describes the growth of a nail plate in a location other than the usual nail unit, which can be congenital or associated with trauma.1 2 Management of ectopic nail ranges from observation to excision and is guided by the appearance of the nail, symptom severity, and functional impairment.3bmj;379/nov09_9/e072014/F1F1f1Fig 1
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