A small exostosis on the dorsum of the distal phalanx can result in severe pain. The exostosis pushes the nail upwards.
Patients will generally complain of pain when shoes are worn, and often of increasing discolouration of the nail with associated swelling and elevation of the nail plate. A common result of this condition is subungual corn or callus formation, and sometimes secondary infection.
Treatment is via excision of the exostosis.
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