Finger Pulp Research Articles

Medial pantar venous flap for reconstruction of different locations of digital soft tissue defects

Objective To investigate procedures and clinical effects of medial plantar venous flaps in reconstruction of different sites of finger soft tissue defects.Methods From March 2010 to April 2012,29 cases (31 fingers) of soft tissue defects in different sites were treated with medial plantar venous flaps,including 11 finger tip defects (13 fingers),7 finger back defects (7 fingers),11 finger pulp defects (11 fingers).Size of the defects ranged from 1.2 cm× 1.5 cm to 2.5 cm × 3.5 cm.Size of the flap ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.0 cm.Donor sites were covered with full thickness skin graft.Results ALL flaps survived,except for one with arterial crisis and two with venous crisis,which were cured after timely vascular exploration and arteriovenous anastomosis.Donor and recipient sites were healed by first intention and skin grafts in donor sites survived.Twenty-four cases (26 fingers) were followed up for 4 to 12 months.Texture and color of the flaps were similar to those of adjacent normal skin,with a satisfactory appearance.Fingerprint and protective sensation were attained for soft tissue defects of the finger tip and pulp after operation.Conclusion Medial plantar venous flap is an ideal surgical option for reconstruction of finger soft tissue defect,for it has advantages of good effect and less damage to donor sites. Key words: Surgical flaps ; Hand ; Soft tissue injuries ; Repair

The clinical experience of replantation of avulsed finger pulp

Objective To discuss the surgical indications and methods of replantation of avulsed finger pulp.Methods From 2008 to 2010,43 cases of 45 finger pulp tissue pieces were replanted.The digital artery and volar digital vein were both anastomosed in 23 fingers.In 12 fingers only volar veins were anastomosed for arterialization to perfuse the replants.Converting anastomosed digital artery for venous drainage was done in 6 fingers.The rest 4 fingers did not have anastomosis of the volar veins.Instead venous drainage was achieved by placing a rubber drain in the wound which was dripped with normal saline.Results Replants of 36 fingers survived,accounting for an 80％ survival rate.Of these 36 survivals,25 fingers were follow-up while 11 fingers were lost to follow-up.The follow-up time ranged from 6 months to 3 years.Survival fingers all had good appearances and good functional recovery.Pain,temperature and touch sensation were restored to the replants 3 to 9 months postoperatively (average,6 months).Two-point discrimination of the pulps reached 3 to 7 mm.Conclusion The function and appearance of the replanted finger pulp are good if the replanted avulsed finger pulp tissue survives.Every effort should be made to replant the avulsed piece when the tissue is intact and there is blood vessel for anastomosis. Key words: Finger injuries; Replantation; Finger pulp avulsion

Microsurgical Reconstruction of Partial and Total Amputation of the Finger Nail Apparatus

Introduction: Amputation and defect of the finger nail system is a relatively frequent pathology often associated to the injury and amputation of the finger pulp. Its reconstruction is often neglected instead of the reconstruction of the skin finger pulp.

Dorsal digital advancement flaps vascularized with digital arteries for repair of finger pulp defect

Objective To investigate the effect of dorsal digital island advancement flaps accompanied with digital arteries in reconstruction of finger pulp defect.Methods The study enrolled 36 cases (43 fingers) of pulp soft tissue defect treated from October 2007 to July 2011.There were 25 males (30 fingers) and 1l females(13 fingers),at age of 12-62 years (mean 34.5 years).Causes of injury included crushing in 19 cases (16 fingers),squeezing in 13 (16 fingers) and cutting in 4 (5 fingers).The fingers involved were the index (11),the middle (18),the ring (9),and the little (5).All wounds revealed the exposed bone with defect area ranging from 1.2 cm × 1.0 cm to 2.6 cm × 2.0 cm.Dorsal digital island flaps accompanied with digital artery were used for finger reconstruction and sensation was restored by anastomosing to dorsal branch of digital nerve.Donor sites were closed using skin grafts.Results All flaps survived.Thirty-three cases (39 fingers) were followed up for 5-26 months (mean 14.5 months).The flaps revealed satisfactory appearance,soft texture and good elasticity.The injured fingers were pain-free.Two point discrimination was 5-8 mm (mean 6.7 mm).According to the upper limb function criteria formulated by Hand Surgery Branch of Chinese Medical Association,the results were excellent in 24 fingers,good in 13 fingers,and fair in 2 fingers,with the excellence rate of 95％.Conclusion Dorsal digital advancement island flap vascularized with digital artery is relatively the best for finger pulp coverage,for the procedure is easy and safe,with satisfactory result. Key words: Finger injuries; Surgical flaps; Reconstruction

A Comparison of the Dorsal Digital Island Flap with the Dorsal Branch of the Digital Nerve versus the Dorsal Digital Nerve for Fingertip and Finger Pulp Reconstruction

Traumatic fingertip and finger pulp defects can be treated with dorsal digital island flaps. Either the dorsal branch of the digital nerve or the dorsal digital nerve can be included in the flap for sensory reconstruction. However, it is still unclear whether there are differences in the results between the two donor nerves. A retrospective study was conducted in 71 patients who had a fingertip or finger pulp defect treated with an innervated dorsal digital island flap from February of 2005 to June of 2011. The patients were divided into two groups based on which donor nerve was chosen. The donor nerve was coaptated to the digital nerve in the defect. At the final follow-up, the two groups were compared for static two-point discrimination, Semmes-Weinstein monofilament scores, pain, cold intolerance of the reconstructed finger, and patient satisfaction. Significant differences were found in static two-point discrimination, pain, cold intolerance, and patient satisfaction (p < 0.05). The dorsal branch group presented slightly better discriminatory sensation in the flap and lower incidence of pain and cold intolerance in the injured finger. In addition, the dorsal branch group had a larger degree of satisfaction than the dorsal digital nerve group. No significant differences were found regarding Semmes-Weinstein monofilament flap score and total active motion of the finger. When utilizing dorsal digital island flaps to reconstruct traumatic fingertip and finger pulp defects, choosing the dorsal branch rather than the dorsal digital nerve as the donor may attain better outcomes. Therapeutic, III.

Aesthetic and Sensory Reconstruction of Finger Pulp Defects Using Free Toe Flaps

This study illustrates aesthetic and sensory reconstruction of finger pulp defects with free toe flaps from the lateral aspect of the great toe or the medial aspect of the second toe. Between August 2007 and July 2010, free toe flaps were harvested and used for 21 fingers of 21 patients. The average patient age was 34.5years (range 19-62years). The soft tissue defects were found in the thumb of 6 patients, the index finger of 7 patients, the middle finger of 5 patients, and the ring finger of 3 patients. The donor site was the great toe for 9 patients and the second toe for 12 patients. The average flap size was 2.8×2.0cm (range 1.7×1.7 to 3.5×3.0cm). Restoration of the sensitivity, aesthetic appearance, and mobility of the injured fingers compared with the opposite side was assessed using appropriate tools during the follow-up time. All the flaps in this series survived completely, with a high survival rate of 100%. No urgent operative revision necessitated by postoperative thrombosis of the vessels was performed during the follow-up period. During a mean follow-up period of 18.4months (range 12-24months), the average static two-point discrimination score for the injured finger pulp was 4.8mm (range 3-7mm), and the Michigan Hand Outcome Questionnaire score was 4.9mm. The mean range of motion of the distal interphalangeal joint in the injured finger was 69.7°. Transplantation of free microvascular flaps from the great toe or the second toe is a useful and reliable technique for finger pulp defect reconstruction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Tactile Sensibility on the Fingernail

To measure tactile discrimination (static and moving 2-point discrimination) and threshold levels (Weinstein enhanced sensory test) over the nail plate in normal subjects and compare these values with those at the corresponding finger pulps. Tactile discrimination and threshold values over the nail plates and finger pulps were measured on 300 digits in 30 healthy subjects with a mean age of 23 years. Subjects with cosmetic nail modifications, injuries, neurological deficits, dermatological conditions, or history of upper limb surgery were excluded. Equivalence testing was conducted to look for clinical equivalence between values obtained at both sites. The mean static 2-point discrimination, moving 2-point discrimination, and threshold value over the human nail were 6.7 mm, 2.4 mm, and 0.06 g, respectively. The corresponding values for the finger pulp were 2.4 mm, 2.2 mm, and 0.01 g, respectively. The static 2-point discrimination and threshold values were superior for the finger pulp, whereas moving 2-point discrimination values at both sites were clinically equivalent. Our study suggests that tactile discrimination and threshold levels can be measured over the nail plate and that moving 2-point discrimination values are clinically equivalent to those obtained on the corresponding pulp. This highlights the importance of the nail plate in the sensory function of the fingertip. The normative data from this study may be useful in establishing the impact of nail injury and the contribution of the nail to the overall function of the hand. Diagnostic II.

Applied anatomy of antegrade neurovascular island flap from the same finger

Objective To investigate the micro-anatomical structures of the antegrade neurovascular island flap and provide anatomical basis of using this flap from the same finger for repairing finger pulp defects.Methods Twenty adult cadaver hand specimens were dissected under a surgical microscope.Anatomical structures of the neurovascular bundle of the flap were observed and the flap advancing distance was measured.Results The advancing distance of the island flap was (16.7± 1.4) mm in the thumb,(18.5± 1.2) mm in the index finger,(19.7± 1.8) mm in the middle finger,(18.1 ± 1.0) mm in the ring finger and (15.8 ±1.2) mmin the little finger.Overall the flap could be advanced about 1.5 to 2.0 cm.Another 0.5 cm advancement could be achieved when the metacarpophalangeal joint and proximal interphalangeal joint were flexed for 15° to 20°.The maximum advancing distance should not exceed 2.0 to 2.5 cm.Conclusion Advancement of antegrade neurovasctlar island flap from the same finger offers a sensate skin flap for coverage of finger pulp defect.The surgical technique is simple,and the clinical results are satisfactory.It is an ideal method for reconstruction of thumb or finger pulp defects. Key words: Surgical flaps; Anatomy, regional; Island flaps

Rotation advancement flap to repair fingertip defects

Objeetive To investigate the application and clinical efficacy of rotation advancement flap for repairing fingertip defects.Methods From February 2009 to December 2011 rotation advancement flap was used to treat 18 fingertip defects in 15 cases.Results Primary wound healing was achieved in all 15 cases.All the rotation advancement flaps survived.13 cases were follow-up for 4 to 15 months (average,7.2 months)while 2 were lost to follow-up.There was no hypertrophic scar.Finger movement was good.The finger pulp was as well perfused and full as a healthy finger.Two-point discrimination of the finger pulp was 3 to 8 mm.Finger pinch was normal.Conclusion Rotation advancement flap is a simple and effective option for repairing fingertip defects.It results in ideal appearance of finger pulp and fingertip. Key words: Surgical flaps; Finger injuries; Treatment outcome

Reconstruction of a neurocutaneous defect of the proximal phalanx with a heterodigital arterialised nerve pedicle flap

BackgroundComplex digital injuries involving soft-tissue loss and digital nerve defect pose a challenging problem for hand surgeons. The purpose of this study was to evaluate the efficacy of transferring the heterodigital arterialised nerve pedicle flap for reconstructing the digital neurocutaneous defects and to compare the results with those of transferring the cross-finger flap and secondary nerve grafting. MethodsFrom March 2008 to September 2011, the nerve pedicle flap was used in 12 patients who had a combination of soft-tissue and digital nerve defects. The injured fingers included four index, four long, three ring and one little finger. The mean size of the soft-tissue losses was 2.4×1.9cm (range, 2.3×1.3 to 3.2×2.0cm). The mean flap size was 2.6×2.1cm (range, 2.5×1.5 to 3.4×2.2cm). The length of the nerve defects ranged from 1.5 to 3.8cm (mean, 2.8cm). The nerve defect was reconstructed with transfer of the digital nerve dorsal branch. For comparison, we collected a series of 24 patients with similar defects treated with the cross-finger flap and secondary free nerve grafting. ResultsSignificant differences were found between the two groups in static two-point discrimination (p<.01) and pain (p=.03) in the reconstructed finger. In comparison, the study group presented better discriminatory sensation on the finger pulp and lower incidence of pain sensibility in the injured finger. There was no significant difference in cold intolerance and Semmes–Weinstein monofilament. In the study group, the total active motion of the donor fingers was similar to that of the opposite hands. ConclusionsThe heterodigital arterialised nerve pedicle flap is useful and reliable for reconstructing the neurocutaneous defects in the proximal phalanx. Comparable sensory recovery and lower pain incidence can be achieved using our nerve pedicle flap instead of conventional nerve grafting. Type of study/level of evidenceTherapeutic II.

Treatment of Distal Fingertip Degloving Injuries Using a Cross-Finger Flap Based on the Dorsal Branch of the Proper Digital Artery at the Middle Phalanx

This study reports our experience with reconstruction of distal fingertip degloving injuries using a single cross-finger flap based on the dorsal branch of the proper digital artery at the middle phalanx. From January 2009 to October 2011, 18 patients (18 fingers) presented with distal fingertip degloving injuries and were treated with this technique. The mean size of the soft tissue defects was 4.5 cm in length and 2.0 cm in width. The mean size of the cross-finger flaps was 4.7 × 2.1 cm. In the series, all flaps survived completely. No complication was reported, and no further flap debunking procedure was required. At the mean follow-up period of 20.5 months (range, 12-48 mo), the mean static two-point discrimination was 6.3 mm (range, 5-9 mm) of the reconstructed finger pulp. The total range of active motion of the proximal and the distal interphalangeal joints of the donor fingers were 105 and 77.4 degrees, respectively. The cross-finger flap based on the dorsal branch of the proper digital artery at the middle phalanx is a reliable and simple method in reconstruction of distal degloving injuries of the finger.

The application of hallux dorsal artery flap for repairing f＇mger pulp defect

Objective To investigate the clinical efiqcacy of repairing finger pulp defect with hallux dorsal artery flap. Methods Finger pulp defect in 11 cases was treated with free transplantation of hallux dorsal artery flap. Flap sizes ranged from 2.0 cm × 1.5 cm to 3.5 cm× 2.5 cm. Results Flap survival was uneventful in 10 cases. Vascular crisis occurred in 1 flap. Surgical exploration and reanastomosis of the vessels rescued the flap that survived. The patients were follow-up for 1 month to 2 years. The appearance and texture of 10 flaps were satisfactory. Two-point discrimination was 5 to 8 nun. All affected fingers had normal pinch. Bulkiness and stiffness of the flap was treated with plastic surgery which greatly improved flap appearance in 2 cases. Walking of the donor foot was normal. Conclusion Hallux dorsal artery flap transplantation leads to good clinical results and is an ideal flap for repairing of finger pulp defects. Key words: Finger injuries; Surgical flaps; Microsurgery

Use of a bipedicled nerve flap taken from the dorsum of the digit for reconstruction of neurocutaneous defect in the adjacent finger

A digital nerve defect complicated by an associated soft-tissue loss poses a reconstructive challenge. This article reports reconstruction of a similar complex injury using a bipedicled nerve flap including a nerve graft from the dorsal branch of the digital nerve. From July 2008 to May 2010, a retrospective study was conducted with nine consecutive patients who had a combination of soft tissue and digital nerve defects. The injured fingers requiring reconstruction included three index, four middle and two ring fingers. The mean size of the soft-tissue losses was 2.8×2.1 cm. The flap is supplied by the digital artery and the venous drainage is by means of a dorsal vein. The mean flap size was 3.1×2.3 cm. The nerve gaps were bridged with the nerve graft attached with the flap. The average length of the nerve grafts was 3.0 cm. All flaps survived completely, and the defects were reconstructed successfully. Venous congestion was not observed in our series. At a mean follow-up period of 23 months, the average scores of static two-point discrimination (2PD) and Semmes-Weinstein monofilament on the finger pulp of the injured side were 7.5 mm and 3.93, respectively. The donor site morbidity was acceptable. According to the Michigan Hand Outcomes Questionnaire, four patients were strongly satisfied and five were satisfied with functional recovery of the injured finger. The bipedicled nerve flap is a safe and effective option for reconstruction of complex digital injury involving soft tissue and nerve defects. Our technique has been shown to provide sufficient sensory recovery. ClinicalTrials.gov ID: NCT01707654. Therapeutic IV.

Clinical research on finger lateral veins anastomosis for restoring venous return of severed fingertip

Objective To investigate effect of finger lateral veins anastomosis for restoring venous return of severed fingertip.Methods From March 2008 to December 2012,36 patients underwent finger lateral veins anastomosis,including 21 males and 15 females,aged from 15 to 52 years (average,29.5±6.6 years).The thumb was involved in 3 cases,the index finger in 9 cases,the middle finger in 9 cases,the ring finger in 7 cases,and the little finger in 8 cases.The causes of injury included crush injury in 12 cases,electric saw injury in 8 cases,and incised injury in 16 cases.According to type of fingertip injury,there were 14 cases of type Ⅰ,5 cases of type Ⅱ,10 cases of type Ⅲ,and 7 cases of type Ⅴ.The ratios of anastomotic artery and veins were 1∶1,1∶2 or 2∶2 (average,1∶2).Results Thirty-six fingertips survived completely and no venous return obstruction happened,arterial crisis occurred in 3 cases after operation,which were cured after operative and medication treatment.Thirty patients were successfully followed up for 6 to 24 months (average,12.4±2.8 months).The fingers' appearances were satisfactory,finger pulps were plump with good flexibility,and no obvious atrophy of finger was found.The nails were nearly smooth,and the length of nails ranged from 10.5 to 18.9 mm (average,14.4±3.2 mm).The motion of distal interphalangeal joints,the two point discrimination,and the results of sensation measurement ranged from 0° to 70° (average,63°±5°),4.2 to 6.0 mm (average,4.6±0.4 mm),and S3 to S4,respectively.According to Tamai's classification,Tamai score increased from 68 to 100 at final follow-up,the results were excellent in 28 cases,good in 2 cases,with an excellent and good rate of 100％.Conclusion The finger lateral veins anastomosis is an effective method for restoring venous return of severed fingertip,which can avoid venous return obstruction,promote growth of nail,and restore motion and sensation of fingers. Key words: Finger injuries; Veins; Replantation; Reconstructive surgical procedures

Clinical application of reconstructive surgical procedures of thumb

Objective To summarize the surgical methods and clinical efficacy of the thumb fullshaped reconstruction.Methods Fourteen cases with Ⅲ and Ⅳ degree thumb defect were underwent the thumb full-shaped reconstruction from March 2010 to May 2012.According to the region need,cutting the hallux toenail flap and second toe bone flap of the same vascular pedicle,and then the hallux toenail flaps wrapped second toe bone flap was transferred to reconstruction of thumb shape and function.Hallux toenail flap donor site was repaires with second toenail flap.Results Thumbs of 14 cases were all survived.Vasospasm were occurred in 2 cases at operation and were relieved by lidocaine dropped outside vascular and local fomentation by warm saline.The remaining 12 cases of thumb reconstruction survived successfully.Fourteen patients were followed up for 6-18 months(12 months on average).Except for 1 case of nail irregularity,the remaining reconstructive thumb recovered well.The appearance was the same as contralateral one.The flexion and extension function were recovered.The two-point discrimination of the finger pulps was ranged from 6mm to 8 mm.According to the trial standard of upper limb part of functional assessment of the Hand Surgery Branch of Chinese Medical Association,among the 14 cases,there were excellent in 7,good in 6,and fair in 1,with an excellent and good rate of 92.9％.Conclusion Hallux nail flap combined with second toe bone flap of the same vascular pedicle was transferred to repair and reconstruct thumb of appearance and function.Although the difficulty and risk of operation is large,after reconstruction the appearance and function of thumb is good.This technique is an ideal procedure and worthy of promotion. Key words: Thumb; Hallux nail flap; Second toe bone flap; Full-shaped reconstruction; Microsurgery

Noninvasive methods for haemoglobin screening in prospective blood donors

The haemoglobin level of prospective blood donors is usually performed on blood obtained by from the finger pulp by fingerstick with a lancet and filling a capillary tube with a sample. New noninvasive methods are now available for rapid, noninvasive predonation haemoglobin screening. Prospective blood donors at our blood centre were tested, in two different trials, as follows: by the NBM 200 (OrSense) test (n = 445 donors) and by the Pronto-7 (Masimo) test (n = 463 donors). The haemoglobin values of each trial and the haemoglobin of finger pulp blood obtained by fingerstick with a lancet (HemoCue) were compared with the haemoglobin values obtained from a venous sample on a Cell Counter (Beckman Coulter). Comparison of Beckman Coulter Cell Counter and OrSense and results showed a bias of 0.29 g/dl, the standard deviation of the differences (SDD) of 0.98 and 95% limits of agreement from -1.64 to 2.21, using Bland and Altman statistical methodology. Comparison of Masimo and Beckman Coulter Cell Counter results showed a bias of -0.53 g/dl, SDD of 1.04 and 95% limits of agreement from -2.57 to 1.51. Cumulative analysis of all 908 donors, as tested by the usual fingerstick test showed a bias of 0.83 g/dl, SDD of 0.70 and 95% limits of agreement from -0.54 to 2.20 compared with the Coulter Cell Counter. Compared with the Coulter Counter, the specificity of the methods was 99.5% for fingerstick, 97% for OrSense and 83% for Massimo, and the sensitivity was 99, 98 and 93%, respectively. Analysis of finger pulp blood by either direct sampling by fingerstick and Hemocue, or by noninvasive haemoglobin tests does not replicate the results of cell counter analysis of venous samples. Compared with fingerstick, noninvasive haemoglobin tests eliminate pain and reduce stress, but have a lower level of specificity and sensitivity.

Distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch to repair fingertip defects

Objective To analyze the clinical outcomes of treating fingertip defects with distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch.Methods Twenty-three cases with soft tissue defects in the pulp or dorsum of the fingertip were treated by the distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch from July 2010 to January 2012.Results All 23 flaps survived completely.Twenty-one cases were follow-up from 3 to 15 months with an average of 6.7 months postoperatively,while 2 cases were lost.One flap for repair of the middle finger pulp shrank postoperatively and the bone was exposed.Stump revision was done.The other 20 flaps were with proper thickness,supple texture and good color.There was no donor site tendon adhesion or scar retraction that impairs joint movement.According to the criteria for functional assessment of the upper extremity issued by the Chinese Hand Surgery Society,the overall good-excellent rate was 87％.Conclusion Distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch is a satisfactory method for treatment of fingertip defects. Key words: Finger injuries; Surgical flaps; Treatment outcome; Proper digital nerves

Impaired vibrotactile sense at low frequencies in fingers in autoantibody positive and negative diabetes

Vibration thresholds in index and little finger pulps in subjects with autoantibody [GADA, IA-2A and/or ICA] positive and negative diabetes 20 years after diagnosis were higher than in age-matched controls at low frequencies (8 and 16Hz), irrespective of HbA1c values, indicating selective impairment of Meissner's corpuscles and/or their innervating axons.

Localisation inhabituelle pulpaire d’un kyste trichilemmal proliférant

Trichilemmal cyst is a benign tumor, developed from hair follicle, located mainly at the scalp. We report a clinical case of unusual location at the finger pulp confirmed by histology. The main differential diagnosis in this reported case was a whitlow. The origin of this cyst is probably the nail matrix whose keratinization is trichilemmal. Surgical excision biopsy allowed a good clinical outcome.

Soft tissue chondroma of the index finger: Clinical, histological and radiological findings in a unique case

A chondroma is a benign, slow-growing cartilaginous tumor. When arising in the medullary cavity of a bone it is referred to as an enchondroma-a very common bone tumor. When occurring in soft tissue without any connection to bone, which is extremely rare, it is known as a soft-tissue chondroma (STC). A 38-year-old female presented with a 2- year history of right index finger pulp swelling in the absence of trauma. On physical examination a firm, immobile nodule, approximately 1 cm in diameter, was observed on the palmar side of the right index finger. The overlying skin was normal. Plain X-ray showed a dense, soft tissue shadow without calcification in the right index finger pulp, but the adjacent bones were intact. MRI showed a 1-cm diameter, well-demarcated lesion with intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. MRI also showed that the tumor had no bony involvement and that the adjacent bones were normal. Histopathological examination of the biopsy specimen showed lobules of mature hyaline cartilage with chondrocytes in the lacunae in the dermal and subdermal layers. Mitotic figures and an increase in cellular atypism were not observed. Based on the histopathological and radiological findings, the mass was thought to be an STC and total excision was performed. Examination of the excised mass confirmed the diagnosis of STC. STC should be considered in patients with a slowly growing, mildly painful cutaneous mass.