What are the other Names for this Condition? (Also known as/Synonyms)

• Onychopapilloma of the Nail Bed

What is Onychopapilloma? (Definition/Background Information)

• Onychopapilloma is a rare, benign tumor affecting the nail matrix and nail pulp. It can affect any nail and may be painful
• Onychopapilloma is generally seen in middle-aged and older adults. Presently, the cause of the tumor is unknown and there are no identified risk factors
• The tumor underneath the nail may push the nail upwards causing its dislodgement. In some cases, Onychopapilloma can lead to bleeding. It can also result in secondary infections
• A simple surgical excision of the tumor is considered curative. The prognosis for Onychopapilloma is excellent with adequate treatment

Who gets Onychopapilloma? (Age and Sex Distribution)

• Onychopapilloma is an uncommon tumor that is present during adulthood; middle-aged and older adults are typically affected
• Both males and females may be affected
• Individuals of all racial and ethnic background may be affected

What are the Risk Factors for Onychopapilloma? (Predisposing Factors)

• Currently, no specific risk factors have been identified for the formation of Onychopapilloma

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Onychopapilloma? (Etiology)

The exact cause of development of Onychopapilloma is presently unknown.

What are the Signs and Symptoms of Onychopapilloma?

The signs and symptoms of Onychopapilloma include:

• The presence of a benign tumor below the nail; the nail matrix and pulp may be affected
• It occurs as a single lesion on one nail; any nail may be affected
• The tumor may cause the nail to be lifted and disfigured (called onycholysis); this process is painless
• The nail usually shows longitudinal red streaks, called erythronychia
• Sometimes, white longitudinal streaks called leukonychia, or brown streaks called melanonychia, may be observed. However, red streaks are far more common than whitish/brownish nail discoloration

How is Onychopapilloma Diagnosed?

A diagnosis of Onychopapilloma may involve the following:

• A thorough medical history and physical examination
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin (nail) using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Biopsy of the lesion: A biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis may be undertaken prior to arriving at a definite diagnosis by eliminating the following conditions:

• Amyloidosis
• Benign tumor of the blood vessels
• Darier disease (a condition that may affect multiple nails)
• Glomus tumor
• Lichen planus
• Squamous cell carcinoma and basal cell carcinoma of the nail unit
• Subungual melanoma
• Viral wart
• Warty dyskeratoma

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Onychopapilloma?

Onychopapilloma is a rare tumor and it may cause the following complications:

• The tumors can bleed and result in secondary bacterial or fungal infections (superimposed infections)
• It can also become infected, if the tumor is left untreated or treated inadequately
• Loss of nail (that may be partial or complete)

How is Onychopapilloma Treated?

The treatment of Onychopapilloma may involve the following procedures; it also depends upon each individual’s specific circumstances:

• Complete surgical excision: In a majority of cases, the tumor is removed
  • The entire nail may have to be avulsed/removed to facilitate removal of the entire tumor
  • This can result in a complete cure; the removed nail usually grows back normally
• Treatment of any secondary infections may be undertaken through antibiotics or antifungal medications
• Follow-up care with regular check-up is encouraged

How can Onychopapilloma be Prevented?

Currently, there are no known methods to prevent Onychopapilloma occurrence.

What is the Prognosis of Onychopapilloma? (Outcomes/Resolutions)

The prognosis for Onychopapilloma is excellent with appropriate treatment, since it is a benign tumor.

Additional and Relevant Useful Information for Onychopapilloma:

• Care must be taken avoid strong soaps and chemicals that can potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse