English

Abstract

Glomus Tumour is an uncommon, painful entity arising from the arterial end of the glomus body. We report an interesting case of chronic severe obscure pain in the finger tips with the complete longitudinal splitting of nail. Love Test (eliciting point tenderness on pressing the swelling with tip of pen) was positive in our case and the patient had increased sensitivity to cold temperature. Hildreth test (disappearance of the pain after application of a tourniquet proximally on the arm in case of glomus tumour) was negative in our case. Colour Doppler helped to diagnose the presence of mass in subungual area. Patient was treated with the excision of the swelling along with nail. Histopathological finding confirmed the diagnosis of the subungual glomus tumour. Longitudinal splitting of the nail due to underlying glomus tumour is a unique presentation which will help in making clinical diagnosis and examining patient of glomus tumour with such presentation on clinical grounds. INTRODUCTION: An interesting case of subungual glomus tumour causing longitudinal splitting of the nail, resembling median canaliform dystrophy of nail, is being reported. Longitudinal splitting of the nail as seen in median canaliform dystrophy is commonly seen following chronic trauma to the nail or nail bed. However, underlying tumors of the matrix can also cause longitudinal splitting. We report an atypical complete longitudinal splitting of nail due to underlying glomus tumour. CASE HISTORY: A 22 year old female reported to the Surgical OPD with an exquisitely painful right hand little finger, which was also a complete longitudinal split from the proximal nail bed. She reported that she was apparently alright 8 years ago when she developed pain over right hand little finger nail bed and fingertip which use to radiate over same hand and in last two years patient has developed longitudinal split (Figure no. 1& 2) starting from free end of nail plate .The longitudinal split grew during this period towards proximal nail fold. She complained of severe pain, point tenderness was present as suggested by positive Love test (eliciting tenderness on pressing the point with tip of pen). She also complained of increased sensitivity to cold temperature. There was no history of drug intake or any family history of a similar affliction. There was no history of any repeated trauma or any habit of tic involving