Glomus tumor of the fingernail?

From the Guidelines

Glomus tumor of the fingernail is a small benign tumor that presents with localized tenderness, severe paroxysmal pain, and sensitivity to cold 1.

Key Characteristics

• Benign nature: Glomus tumors are non-cancerous growths that arise from the glomus body, a specialized vascular structure.
• Symptoms: Patients often experience intense pain, tenderness, and sensitivity to cold, which can be debilitating.

Diagnosis and Treatment

• Imaging studies: MRI or ultrasound may be used to confirm the diagnosis, although a thorough physical examination is often sufficient.
• Surgical excision: Treatment typically involves surgical removal of the tumor, which can be performed under local anesthesia.
• Goal of treatment: The aim is to remove the tumor completely while preserving the nail and surrounding tissue.

Management Considerations

• Pain management: Over-the-counter pain medications such as acetaminophen or ibuprofen may be prescribed to manage pain before and after surgery.
• Antibiotic prophylaxis: A short course of oral antibiotics may be given to prevent infection.
• Specialist referral: It is essential to seek medical attention from a qualified healthcare professional, such as a dermatologist or a hand surgeon, for proper evaluation and treatment of a glomus tumor of the fingernail.

Important Associations

• Neurofibromatosis type 1 (NF1): Patients with NF1 have a 200-fold increased risk of developing certain tumors, although the association with glomus tumors is not explicitly stated in the provided evidence 1.

From the Research

Characteristics of Glomus Tumor of the Fingernail

• Glomus tumors are rare, benign vascular neoplasms commonly found in the hand, particularly in the subungual region 2, 3
• They typically present as a bluish or pinkish red discolouration of the nail plate with a classical triad of localized tenderness, severe pain, and cold sensitivity 2, 3, 4, 5
• The tumors usually arise from the neuroarterial plexus concentrated beneath the nailbed, and are more common in women of age group 20-40 years 4

Diagnosis of Glomus Tumor of the Fingernail

• Diagnosis can be delayed due to the rarity and benignity of the tumor, as well as lack of proper knowledge about the condition 3, 4
• Clinical tests such as Love's pin test, Hildreth's test, and trans-illumination test can be helpful in diagnosis 2
• Imaging studies such as magnetic resonance imaging (MRI), ultrasonography, and radiography are often used to aid in diagnosis 2, 3, 4, 6
• Histopathologic examination is confirmatory 3, 5

Treatment of Glomus Tumor of the Fingernail

• Complete surgical excision is the curative treatment for glomus tumor, and is crucial to prevent recurrence and relieve symptoms 2, 3, 4, 6, 5
• Different surgical approaches can be used, including transungual approach with complete excision of the nail plate, which can reduce the risk of reoccurrence and post-operative nail deformity 6