Accessory nail of the right index finger following trauma

A 35-year-old man presented with a hard, curved, nail-like projection arising adjacent to the right ring-finger nail for 1 year.e lesion was asymptomatic.He reported a history of trauma to the same finger 2 years earlier.Examination revealed a separate, well-defined, translucent keratin plate distal to the proximal nail fold, distinct from the main nail [Figure 1].Dermoscopy was performed using contact polarized (10x) mode with a liquid interface, which demonstrated parallel longitudinal striations with a smooth, shiny surface, and absence of vascular or hemorrhagic structures, consistent with an accessory (ectopic) nail [Figure 2].e patient was counseled regarding the benign nature of the lesion.Surgical excision was advised; however, he opted for conservative management as the lesion was asymptomatic.Ectopic nail (onychoheterotopia) is a rare entity, with fewer than 100 cases reported in the literature. [1]It may be congenital or acquired following traumatic implantation of nail matrix cells.Surgical excision of the ectopic matrix is the definitive treatment. [2]Recognition of this benign condition prevents misdiagnosis as onychomatricoma or cutaneous horn.