Subungual Exostoses as an Infrequent Cause of Pain and Nail Plate Deformities of the First Toe: A Retrospective Cohort Study

Background

Toenail deformities are a frequent reason for medical consultation. The etiology is not always well understood, particularly in cases without trauma, where abnormal nail growth conditions have been excluded, and microbiological cultures yield negative results. Thus, identifying the underlying cause of toenail anomalies can be challenging. Patients often do empirical treatments—i.e., antifungals—for extended periods without achieving remission. Subungual exostoses, on the other hand, are an important consideration in the differential diagnosis of subungual pain, particularly in the first toe. Although exostoses have been well documented in the literature, studies specifically examining their role in nail deformity and discomfort are lacking.