10.5826/dpc.1302a153
text/xml
2160-9381
2942
en
Sivaranjini  Ramassamy
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Onychoheterotopia
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-04-29
2022-10-31
2023-04-29
2023-06-05
e2023153
Dermatol Pract Concept
Sivaranjini  Ramassamy
2023/04/29
10.5826/dpc.1302a153
e2023153
Department of Dermatology and STD, JIPMER, Puducherry, India
2160-9381
en
e2023153
Fleury CM, Nasser JS, Aivaz M, Mantilla-Rivas E, Manrique M, Oh AK, et al. Pediatric Ectopic Nail Formation following Fingertip Trauma: A Case Report and Literature Review. Plast Reconstr Surg Glob Open 2020;8:e3291
Onychoheterotopia
https://dpcj.org/index.php/dpc/article/download/2942/2091
                                            Onychoheterotopia
       Kethini Ramadas Ram Kumar1, Arunachalam Narayanan1, Sivaranjini Ramassamy1


1 Department of Dermatology and STD, JIPMER, Puducherry, India



Citation: Ram Kumar KR, Narayanan A, Ramassamy S. Onychoheterotopia. Dermatol Pract Concept. 2023;13(2):e2023153.
DOI: https://doi.org/10.5826/dpc.1302a153
Accepted: November 18, 2022; Published: April 2023
Copyright: ©2023 Ram Kumar et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Sivaranjini Ramassamy, MD, Associate Professor, Department of Dermatology and STD, JIPMER,
Puducherry-605006 E-mail: sivaranjini11@gmail.com




Case Presentation                                                             Although the pathogenesis is unclear, it is hypothesized
                                                                         to occur due to the presence of ectopic germ cells, an under-
A 53-year-old farmer visited our outpatient clinic with an               lying subclinical polydactyly, or traumatic inoculation of nail
asymptomatic, slow-growing, hard, keratotic nail-like struc-             matrix cells [2].
ture growing from the dorsal aspect of his left index finger
(Figure 1) for 40 years following a penetrating injury. On ex-
amination, a 5 x 3 mm rectangular nail plate-like structure,
with a smooth surface, was located 7 mm proximal to the
proximal nail fold. Folds of skin, similar to proximal and dis-
tal nail folds of a normal nail, were seen surrounding it. The
cuticle was not visible. Other nails were normal. No func-
tional disability was noted. Radiographic examination did-
n`t reveal any hypoplasia or thinning of the phalanx. Based
on the above features, a diagnosis of o
                                      ­nychoheterotopia
was made.


Teaching Point
Ectopic nail or onychoheterotopia is characterized by nail
plate growth in regions other than the normal nail bed due               Figure 1. A slow-growing, hard, keratotic nail-like structure grow-
to the presence of an ectopic nail matrix. It is classified into         ing from the dorsal aspect of his left index finger with proximal and
two types: congenital and acquired ectopic nail [1].                     lateral nail folds.




Image Letter | Dermatol Pract Concept. 2023;13(2):e2023153                                                                                  1
    Diagnosis of ectopic nail is made based on its clinical       References
findings and is supported by histopathological evaluation.
Treatment includes surgical excision of the nail and its entire   1. Chatterjee K, Chaudhuri A, Chatterjee G. O  ­ nychoheterotopia:
                                                                     a unique case. Indian J Dermatol. 2013;58(2):150-115.
matrix to prevent recurrence followed by primary closure of
                                                                     DOI: 10.4103/0019-5154.108064. PMID: 23716811. PMCID:
the defect. We present this uncommon condition which has
                                                                     PMC3657221.
differential diagnosis of cutaneous horn, foreign body reac-      2. Fleury CM, Nasser JS, Aivaz M, et al. Pediatric Ectopic Nail For-
tions, and rudimentary polydactyly, and is likely to be missed       mation following Fingertip Trauma: A Case Report and Litera-
by dermatologists.                                                   ture Review. Plast Reconstr Surg Glob Open. 2020;8(12):e3291.
                                                                     DOI: 10.1097/GOX.0000000000003291. PMID: 33425603.
                                                                     PMCID: PMC7787327.




2                                                                       Image Letter | Dermatol Pract Concept. 2023;13(2):e2023153
