Horn on the Nail: Acquired Ungual Fibrokeratoma

Acquired ungual fibrokeratomas are uncommon fibrous tissue tumors that are located in the ungual area. They usually presents as asymptomatic, solitary, smooth, dome-shaped, or fingerlike, flesh-colored papules accompanying nail deformities, including a longitudinal groove and trachyonychia. Acquired periungual fibrokeratoma is considered a topographical variant of acquired digital fibrokeratoma; it has a unique “garlic clove” shape. A traumatic origin has been suggested, as acquired ungual fibrokeratomas occur most frequently on the fingers and toes. Herein, we report a case of a 29-year-old man with growth over left little finger, who was treated with surgical excision of the tissue. Histopathological examination confirmed ungual fibrokeratoma. It is a rare variant of digital fibrokeratoma, and so far the first ungual fibrokeratoma to appear de novo on little finger to the best of our knowledge.