When A Patient Has An Unusual Growth On A Toe

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Key Questions To Consider

1. What essential questions does one still need to ask to help make the diagnosis?
2. What is the tentative diagnosis?
3. Can you list at least three differential diagnoses?
4. What features of this condition differentiate it from other conditions in your differential?
5. What is the suitable treatment of this condition?

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Joel Morse, DPM

1. Hall JC. Sauer’s Manual of Skin Diseases: Eighth Edition. Lippincott Wiliams and Wilkins, Philadelphia, 2000.
2. Bolognia JL, Jorizzo JL, Rapini RP, Ed: Dermatology – Second Edition. Elsevier. Spain. Pp. 1 – 9 and 1033
3. Johnson BL, Moy RL, White GM: Ethnic Skin: Medical and Surgical. Mosby. St. Louis. 1998. Pp.51.
4. Kakurai M, Yamada T, Kiyosawa T, Ohtsuki M, Nakagawa H. Giant acquired digital fibrokeratoma. J Am Acad Dermatol. May 2003;48(5 Suppl):S67-8.
5. Inamadar AC, Palit A, Sampagavi VV, Yelikar BR. Horney projection on hand. Indian J Dermatol Venereol Leprol. 2004;70: 325-326.
6. Kline Satter, E: Acquired Digital Fibrokeratoma in emedicine from web MD, Nov 2007.
7. Braverman IM: Skin Signs of Systemic Disease – Third Edition, WB Saunders Company. Philadelphia. 1998. Pp.548 – 554.
8. Hurst JS, Wilcoski S: Recognizing an Index Case of Tuberous Sclerosis. American Family Physician 2000 Feb 1;61(3): 703-8, 710.
9. Odom RB, James WD, Berger TG: Andrew’s Diseases of the Skin – Ninth Edition. WB Saunders. Philadelphia. 2000.
10. Johnson BL, Moy RL, White GM: Ethnic Skin: Medical and Surgical. Mosby. St. Louis. 1998. Pp.9.
11. Kantrow SM: A 46-Year-Old Man With an Enlarging Finger Nodule. Archives of Pathology and Laboratory Medicine: Vol. 129, No. 8, pp. e179–e180.
12. Meyerle, JH, Keller RA, Krivda SJ: Superficial acral fibromyxoma of the index finger, Dermatology Online Journal 8(2); 22C.

Suggested Reading
13. Kang SB, Lee JY, Cho BK, Houh W: Two Cases of Acquired Periungual Fibrokeratoma. Korean J Dermatol. 1987 Dec;25(6);863-867.
14. Saito S, Ishikawa K: Acquired Periungual Fibrokeratoma With Accessory Germinal Matrix. Journal of Hand Surgery.27(6): 549-555, 2002.

**i**For a related article, see “Treating Difficult Nails In Diabetic Patients” in the March 2006 issue of Podiatry Today.
**i**For other articles, please visit the archives at www.podiatrytoday.com.

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