Subungual glomus tumor is a relatively uncommon entity with varied clinical presentations, leading to diagnostic delays. Onychoscopy can be used as an evaluation tool in the routine evaluation of glomus tumors. Intending to characterize the Onychoscopic features of subungual glomus tumors, we analyzed 15 cases presenting over three years in this observational study. The clinical, Onychoscopic, radiological, and operative findings in these patients were evaluated and correlated depending on the lesions’ location and extent.

All 15 patients, including 11 females and four males, had pain as the presenting symptom and fulfilled the classic triad of paroxysmal pain, cold sensitivity, and positive Love’s pin test. Clinical nail plate findings included onycholysis, onychorrhexis with distal splitting, and Onychoschizia, while nail bed and matrix findings included localized erythematous and bluish patches, longitudinal erythema, and altered lunula. Onychoscopy corroborated the clinical findings and revealed a more extensive area of involvement in five cases. Definitive Onychoscopy findings included localized structureless erythema interspersed with bluish and patchy whitish areas (five cases of the nail bed and six nail matrix tumors) and a “candy‐cane appearance” (six cases, all large and lobulated nail matrix tumors). MRI reported the tumor in 13 patients, while two nail matrix tumors were not there.

Ref: https://onlinelibrary.wiley.com/doi/10.1111/ijd.15358