Acquired digital fibrokeratoma is a rare, benign, fibroepithelial tumor, which commonly presents as a finger-shaped normochromic nodule, typically located at the extremities. When affecting the nails, it usually emanates from the proximal nail fold, rarely arising from the matrix or nail bed. In this report, we describe an unusual case of acquired digital fibrokeratoma located under the nail plate of the right thumb. We describe the clinical, dermoscopic, and histopathological aspects of the lesion, as well as the surgical treatment used, and present a brief literature review on the subject.

Keywords: Nail Diseases; Fibroma; Nails; Skin Neoplasms

Chronic paronychia is an inflammatory condition of the proximal nail fold, often associated with prolonged exposure to moisture and irritant substances. Surgical treatment is indicated in refractory cases. We report the case of a patient with involvement of all digits and an unsatisfactory response to clinical therapies. The square flap technique was employed, yielding favorable functional and aesthetic outcomes. This case highlights the efficacy of the surgical approach and underscores the importance of dermatologists' training in nail surgery techniques.

Keywords: Nails; Paronychia; Nail Diseases