Unveiling subungual exostosis: A case report of prolonged misdiagnosis and successful intervention

Subungual exostosis, a rare and often misdiagnosed condition, presents unique challenges in clinical practice. We present a case of a 19-year-old patient who, over three years, underwent conservative treatment with drugs and two nail removal procedures due to an initial misdiagnosis of fungal infection. Despite these interventions, symptoms persisted, prompting a reevaluation. Radiographic imaging, including anteroposterior and lateral views of the hallux, revealed a well-defined subungual exostosis. Subsequent surgical excision, meticulously performed, confirmed the diagnosis, and histological examination substantiated the presence of subungual exostosis tissue. Remarkably, one-year post-surgery, the hallux nail exhibited complete restoration to normalcy, emphasizing the efficacy of the tailored surgical approach. This case highlights the diagnostic complexities surrounding subungual exostosis, emphasizing the importance of accurate diagnosis and tailored surgical intervention. The successful outcome underscores the transformative impact of precise clinical evaluation and surgical management in resolving prolonged symptoms associated with this rare intra-articular lesion.