Subungual exostosis of the third toe

Subungual exostosis is a variant of osteochondroma that appears as a pinkis h nodule under the free end of the nail plate. It becomes symptomatic when large enough to disrupt the overlying nail on the digit or through mechanic al irritation of the exostosis from physical activity. Appropriate workup o f such a lesion is important, because man), cases of sublingual exostosis a re initially, misdiagnosed by a variety of specialists, including dermatolo gists. With the use of history and roentgenography, sublingual exostosis ca n be effectively diagnosed or excluded. Appropriate treatment of sublingual exostosis can be selected - surgical excision of the lesion with significa nt cure rates achieved. Although most cases of sublingual exostosis are loc alized to the great toe, we describe a 32-year-old woman who developed a su bungual exostosis on ber right third toe. Appropriate diagnostic workup and surgical treatment of the right third-toe exostosis bas resulted in comple te relief of symptoms with no signs of recurrence 7 months after surgery.