Subungual exostosis treated with an in situ thin split-thickness toenail bed graft

Subungual exostosis is a slow-growing, benign outgrowth of normal bone or calcified cartilaginous remains of the distal phalanx. Complete surgical excision of lesions, including the cartilaginous cap, is a unique curative method. An 18-year-old male presented with a protruding papule on the right great toenail. Diagnosis of subungual exostosis had been established and complete excision was performed. In addition, an in situ thin split-thickness toenail bed graft was used to cover the defect. At 6 months after excision, the patient had no complaint of recurrence or pain. We report on a unique trial case of subungual exostosis treated with thin split-thickness nail bed grafts taken from the adjacent normal nail bed of the affected toe.