Onychomatricoma Explained

Specialty:Dermatology

Onychomatricoma is a cutaneous condition characterized by a distinctive tumor of the nail matrix.[1]

Symptoms include thickness of the nail plate, transverse or longitudinal overcurvature, xanthonychia, and numerous splinter hemorrhages.

The diagnosis of onychomatricoma is made based on clinical features, dermoscopy, and ultrasonography, and is confirmed by its histological features.

Onychomatricoma is treated by surgical excision.

Signs and symptoms

Thickness of the nail plate, transverse or longitudinal overcurvature, xanthonychia, and numerous splinter hemorrhage are the four main clinical characteristics of onychomatricoma.[2]

Causes

According to recent research, onychomatricoma patients may have genetic changes, such as chromosomal deletion.[3]

Diagnosis

In addition to the traditional tetrad symptoms, other diagnostic techniques such dermoscopy, ultrasonography, and histological findings are also used to make the diagnosis.[2]

Hemorrhagic striae, white longitudinal grooves that match the nail plate channels, and perforations in the distal region of the nail plate are all visible during dermoscopy.[4]

A radiological examination reveals no evidence of onychomatricoma-related underlying bone involvement.[5]

An ultrasonographic examination reveals poor blood flow, a hypoechogenic region corresponding to the fingerlike projections, and a hypoechoic tumoral lesion affecting the nail matrix.[6]

The diagnosis of onychomatricoma is confirmed by its unique histological characteristics.[2] Onychomatricoma is a fibroepithelial tumour that has two different regions.[7] The proximal zone, which is defined by deep epithelial invaginations occupied by overlaying ungual protrusions, is situated beneath the posterior nail fold. The distal zone, corresponding to the lunula, is made up of epithelial digitations that grow from the matrix epithelium and puncture the nail plate.[2]

Among the differential diagnoses are osteochondroma, longitudinal melanonychia, fibrokeratoma, onychomycosis, periungual fibroma, squamous cell carcinoma, Bowen's disease, and subungual verruca vulgaris.[8]

Treatment

Onychomatricoma is treated with surgical excision.[9] To avoid local recurrence, the tumour must be fully removed, including the normal nail matrix close to the lesion.[10]

Epidemiology

As of 2016 less than 80 cases of onychomatricoma have been reported.[2] The majority of cases of onychomatricoma are middle-aged women, with a peak incidence occurring in the fifth decade of life.[8] [11]

See also

Further reading

External links

Notes and References

  1. Book: Irwin M. . Freedberg . Arthur Z. . Eisen . Klaus . Wolff . K. Frank . Austen . Lowell A. . Goldsmith . Stephen I. . Katz . 2003 . Fitzpatrick's Dermatology in General Medicine . 6th . McGraw-Hill . 978-0-07-138076-8 . 667.
  2. Joo . Hong Jin . Kim . Mi Ri . Cho . Baik Kee . Yoo . Gyeol . Park . Hyun Jeong . Onychomatricoma: A Rare Tumor of Nail Matrix . Annals of Dermatology . Korean Dermatological Association and The Korean Society for Investigative Dermatology . 28 . 2 . 2016 . 237–241 . 1013-9087 . 10.5021/ad.2016.28.2.237 . 27081273 . 4828389 .
  3. Cañueto . Javier . Santos-Briz . Ángel . García . Juan Luis . Robledo . Cristina . Unamuno . Pablo . Onychomatricoma: Genome-wide analyses of a rare nail matrix tumor . Journal of the American Academy of Dermatology . Elsevier BV . 64 . 3 . 2011 . 0190-9622 . 10.1016/j.jaad.2009.07.051 . 573–578.e1. 20691500 .
  4. Richert . B. . André . J. . L'onychomatricome . Annales de Dermatologie et de Vénéréologie . Elsevier BV . 138 . 1 . 2011 . 0151-9638 . 10.1016/j.annder.2010.10.027 . 71–74 . 21276470 . fr.
  5. Miteva . Mariya . Nail Clipping Diagnosis of Onychomatricoma . Archives of Dermatology . American Medical Association (AMA) . 147 . 9 . 2011-09-01 . 0003-987X . 10.1001/archdermatol.2011.240 . 1118. 21931060 .
  6. Soto . Rosamary . Wortsman . Ximena . Corredoira . Yamile . Onychomatricoma: Clinical and Sonographic Findings . Archives of Dermatology . American Medical Association (AMA) . 145 . 12 . 2009-12-01 . 1461–1462 . 0003-987X . 10.1001/archdermatol.2009.312 . 20026866 .
  7. Perrin . Ch. . Goettmann . S. . Baran . R. . Onychomatricoma: Clinical and histopathologic findings in 12 cases . Journal of the American Academy of Dermatology . Elsevier BV . 39 . 4 . 1998 . 0190-9622 . 10.1016/s0190-9622(98)70004-0 . 560–564. 9777762 .
  8. Tavares . Glaysson Tassara . Chiacchio . Nilton Gioia Di . Chiacchio . Nilton Di . Souza . Marcos Vilela de . Onychomatricoma: a tumor unknown to dermatologists . Anais Brasileiros de Dermatologia . FapUNIFESP (SciELO) . 90 . 2 . 2015 . 0365-0596 . 10.1590/abd1806-4841.20153650 . 265–267. 25831003 . 4371682 .
  9. Estrada-Chavez . Guadalupe . Vega-Memije . M. E. . Toussaint-Caire . S. . Rangel . L. . Dominguez-Cherit . J. . Giant onychomatricoma: report of two cases with rare clinical presentation . International Journal of Dermatology . Wiley . 46 . 6 . 2007 . 0011-9059 . 10.1111/j.1365-4632.2007.03300.x . 634–636. 17550569 .
  10. Gaertner . Erich M. . Gordon . Michael . Reed . Thomas . Onychomatricoma: case report of an unusual subungual tumor with literature review . Journal of Cutaneous Pathology . Wiley . 36 . s1 . 2009-09-17 . 0303-6987 . 10.1111/j.1600-0560.2008.01218.x . 66–69. 19469867 .
  11. Di Chiacchio . N. . Tavares . G.T. . Tosti . A. . Di Chiacchio . N.G. . Di Santis . E. . Alvarenga . L. . Stuhr . P. . De Farias . D. . Onychomatricoma: epidemiological and clinical findings in a large series of 30 cases . British Journal of Dermatology . Oxford University Press (OUP) . 173 . 5 . 2015-08-27 . 0007-0963 . 10.1111/bjd.13900 . 1305–1307. 25970230 .

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