Danger in the Nail: Malignant Onychopapilloma

The presentation discusses the concept of malignant onychopapilloma, highlighting its evolution from being considered a benign lesion to recognizing atypical variants that may exhibit malignant characteristics. An instructive case involving a 70-year-old male with an asymptomatic lesion on his left middle finger for two years is presented. The lesion demonstrated a combination of red and yellow colors, splinter hemorrhages, hyperkeratosis, and thinning of the nail plate upon examination. Histopathological analysis showed atypical onychocytes and areas of acanthosis without HPV staining, differentiating it from other nail conditions such as onychocytic carcinoma or Bowen's disease. The speaker emphasizes the recent identification of atypical onychopapillomas, which were asymptomatic and pigmented, and underlines the importance of markers like Ki-67 and P53 in assessing these lesions. The discussion integrates newer research findings and invites future participation in advanced nail histopathology workshops, reinforcing the need for continued exploration of these complex nail pathologies.