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  • Title: Onychomatricoma: clinical and histopathologic findings in 12 cases.
    Author: Perrin C, Goettmann S, Baran R.
    Journal: J Am Acad Dermatol; 1998 Oct; 39(4 Pt 1):560-4. PubMed ID: 9777762.
    Abstract:
    BACKGROUND: Onychomatricoma is a nail matrix tumor that has been well characterized clinically but not histologically. OBJECTIVE: The purpose of this study was to establish histologic criteria for the diagnosis of onychomatricoma to differentiate it from other fibroepithelial tumors of the nail matrix. METHODS: We observed 12 cases and were able to examine 4 of these excised specimens, including the attached nail plate. In 8 patients, avulsion of the nail was performed before excision of the tumor so that the nail plate was examined separately from the tumor. RESULTS: Onychomatricoma is a fibroepithelial tumor consisting of 2 anatomic zones. The proximal zone is located beneath the proximal nail fold with a proximal border starting at the root of the nail and distal border corresponding to the cuticle. It is characterized by deep epithelial invaginations filled with a thick V-shaped keratogenous zone, a thickened nail plate without cavitation but with an undulating inferior border ending in ungual spurs, and a fibrillary stroma clearly demarcated from the undersurface. The distal zone corresponds to the lunula and is characterized by multiple "glove finger" digitations lined with matrix epithelium and oriented around antero-oblique connective tissue axes; perforation of the nail plate by multiple cavities that, generally at the distal edge of the lunula, lose their epithelial digitations and become filled with serous fluid; the connective-tissue stoma of the digitations extends deeply into the dermis and is not demarcated form healthy tissue. CONCLUSION: On the basis of the mentioned characteristics, we have been able to define onychomatricoma histologically. In addition, we have identified an unusual clinical form of onychomatricoma that has the appearance of a cutaneous horn and is situated at the junction of the undersurface of the proximal nailfold and the lateral nailfold.
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