A 49-year-old woman noted the gradual onset of reddish blue discoloration under one fingernail. There was both spontaneous pain and tenderness to palpation.
Key point: A painful and/or tender subungual lesion should suggest a “glomus tumor.” This lesion is also known as a glomangioma and nonchromaffin paraganglioma. It is a benign growth seen more commonly in women than in men and most frequently under the fingernail.
Treatment: The distal nail was removed, and then the lesion was exposed and readily shelled out with a blunt-tipped scissors.
Note: Pain may be induced or worsened by exposure to cold. Severe pain is an indication for surgical removal. Malignant glomus tumors occur but are vanishingly rare.