Subungual Exostosis: Symptoms and Risks

Subungual exostosis is a noncancerous bony growth that develops underneath the toenail or fingernail. This condition can impact a person's health by causing pain, discomfort, and changes in the appearance of the affected nail. It may also lead to difficulty wearing shoes or performing daily activities that involve the affected finger or toe. Subungual exostosis can affect the quality of life of individuals, especially if left untreated, as it can hinder movement and cause ongoing discomfort.

Symptoms of Subungual Exostosis

Subungual exostosis typically presents with specific symptoms related to the nail bed.

Pain and tenderness at the base of the nail
Swelling and redness around the nail
Nail deformity or change in shape
Difficulty wearing shoes or gloves due to the growth
Ingrown toenail caused by the exostosis

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Causes of Subungual Exostosis

Subungual exostosis is primarily caused by repetitive trauma or injury to the nail bed, leading to the development of a bony outgrowth underneath the nail.

Trauma to the nail bed
Chronic irritation or pressure on the nail
Genetic predisposition

Types of Subungual Exostosis

Subungual exostosis can present in different forms, each characterized by distinctive features and manifestations under the nail bed.

Solitary Subungual Exostosis: A solitary bony growth under the nail bed, causing pain and deformity.
Multiple Subungual Exostoses: Multiple bony growths under the nail bed, often associated with underlying bone abnormalities.
Hereditary Subungual Exostosis: Inherited condition leading to bony outgrowths under the nails, potentially affecting multiple family members.
Traumatic Subungual Exostosis: Bony growths under the nail bed resulting from previous trauma or injury to the toe.
Secondary Subungual Exostosis: Bony growths under the nail bed due to underlying conditions such as osteochondroma or enchondroma.

Risk Factors

Subungual exostosis risk factors include trauma to the nail bed, repeated friction or pressure on the toes, and genetic predisposition.

Risk factors for Subungual Exostosis:

Trauma to the nail bed or finger
Repetitive injury to the nail
Genetic predisposition
Chronic infection
Certain occupational activities, such as typing or manual labor

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Diagnosis of Subungual Exostosis

Subungual exostosis is typically diagnosed through a combination of clinical examination and imaging techniques to assess the growth under the nail.

Physical examination
Xray imaging
Biopsy

Treatment for Subungual Exostosis

Subungual exostosis is typically treated by removing the bony growth under the toenail, relieving pain and preventing further damage.

Surgical Removal:

Subungual exostosis can be surgically removed by a podiatrist or orthopedic surgeon to alleviate pain and prevent further nail damage.

Pain Management:

Overthecounter pain relievers or topical medications can help manage the discomfort associated with subungual exostosis.

Protective Padding:

Using protective padding or bandages around the affected toe can help reduce friction and pressure on the exostosis, promoting healing.

Orthotic Devices:

Custom orthotic devices or shoe inserts may be recommended to provide support and alignment to the foot, reducing stress on the affected toe.

Regular Monitoring:

Regular followup appointments with a healthcare provider are essential to monitor the condition, ensure proper healing, and address any potential complications.

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