Meryeme Marhraoui, Kenza Khachani, Meryem El Moustaoui, Syrine Hammada, Mariame Meziane, Karima Senouci
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 8
Date of Publication: 2026/08/19
Ectopic nail, also known as onychoheterotopia, is a rare disorder in which nail tissue develops outside the normal nail unit. Plantar involvement is particularly uncommon. We report a 60-year-old man with treated hypertension who presented with a painful, persistent lesion on the plantar surface of the left foot that had evolved for five years. Examination showed a rounded, exophytic, yellowish plaque measuring 2.2 × 1.5 cm arising within a keratotic nodule on the plantar arch. Dermoscopy revealed furrowed and transverse bands resembling wooden slats, creating a barrel-stave-like appearance. Plain radiography showed no underlying bone abnormality. An initial surgical excision was followed by recurrence at the same site four months later because the ectopic nail matrix had not been completely removed. A second excision with complete removal of the matrix was performed. Histopathological examination confirmed nail tissue with normal keratinization and no atypia. No further recurrence was reported. This case highlights the diagnostic value of clinical and dermoscopic recognition and, most importantly, the need for complete removal of the ectopic nail matrix to prevent recurrence.
Ectopic nail; Onychoheterotopia; Plantar foot; Dermoscopy; Surgical excision
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