Thickness of the nail plate, transverse or longitudinal overcurvature, xanthonychia, and numerous splinter hemorrhage are the four main clinical characteristics of onychomatricoma.[2]
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]
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]
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]
^Freedberg, Irwin M.; Eisen, Arthur Z.; Wolff, Klaus; Austen, K. Frank; Goldsmith, Lowell A.; Katz, Stephen I., eds. (2003). Fitzpatrick's Dermatology in General Medicine (6th ed.). McGraw-Hill. p. 667. ISBN978-0-07-138076-8.
^Cañueto, Javier; Santos-Briz, Ángel; García, Juan Luis; Robledo, Cristina; Unamuno, Pablo (2011). "Onychomatricoma: Genome-wide analyses of a rare nail matrix tumor". Journal of the American Academy of Dermatology. 64 (3). Elsevier BV: 573–578.e1. doi:10.1016/j.jaad.2009.07.051. ISSN0190-9622. PMID20691500.
^Soto, Rosamary; Wortsman, Ximena; Corredoira, Yamile (2009-12-01). "Onychomatricoma: Clinical and Sonographic Findings". Archives of Dermatology. 145 (12). American Medical Association (AMA): 1461–1462. doi:10.1001/archdermatol.2009.312. ISSN0003-987X. PMID20026866.
^Perrin, Ch.; Goettmann, S.; Baran, R. (1998). "Onychomatricoma: Clinical and histopathologic findings in 12 cases". Journal of the American Academy of Dermatology. 39 (4). Elsevier BV: 560–564. doi:10.1016/s0190-9622(98)70004-0. ISSN0190-9622. PMID9777762.
^Estrada-Chavez, Guadalupe; Vega-Memije, M. E.; Toussaint-Caire, S.; Rangel, L.; Dominguez-Cherit, J. (2007). "Giant onychomatricoma: report of two cases with rare clinical presentation". International Journal of Dermatology. 46 (6). Wiley: 634–636. doi:10.1111/j.1365-4632.2007.03300.x. ISSN0011-9059. PMID17550569.
^Gaertner, Erich M.; Gordon, Michael; Reed, Thomas (2009-09-17). "Onychomatricoma: case report of an unusual subungual tumor with literature review". Journal of Cutaneous Pathology. 36 (s1). Wiley: 66–69. doi:10.1111/j.1600-0560.2008.01218.x. ISSN0303-6987. PMID19469867.
^Di Chiacchio, N.; Tavares, G.T.; Tosti, A.; Di Chiacchio, N.G.; Di Santis, E.; Alvarenga, L.; Stuhr, P.; De Farias, D. (2015-08-27). "Onychomatricoma: epidemiological and clinical findings in a large series of 30 cases". British Journal of Dermatology. 173 (5). Oxford University Press (OUP): 1305–1307. doi:10.1111/bjd.13900. ISSN0007-0963. PMID25970230.
