Double-branched transungual acquired fibrokeratoma

Abstract

Sir, Acquired fibrokeratoma (AFK) is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digit. It may appear on the fingers, toes, palms, or soles. Herein, we report an atypical case of AK characterized by its transungual evolution and double-branched form. A sixty-year-old male with a medical history of renal failure due to a chronic kidney disease of unknown etiology consulted for the evaluation of two lesions of the first right toenail evolving for the past one year. The patient recalled a trauma one year before and the subsequent appearance of a cone at the proximal nail fold. Two months later, he noticed another cone emerging from the first. Both lesions were slow-growing and led to the consultation at our department. A dermatological examination revealed two branching, longitudinal, and flesh-colored cones arising from the nail bed (Fig. 1), firm in consistency and with smooth surfaces on palpation.