Authors: Johannes F. Dayrit, MD, FPDS; Lunardi Bintanjoyo, MD; Jerome P. Acosta, MD, DPDS; and Charles A. C. Villamin, MD, FPOA
Introduction: Glomus tumor arises from glomus body and commonly arises on the nailbed but extradigital locations may be involved.
Case Summary: The first case is a 32-year old female with a 1-year history of severe pain on the right thumb upon pressure or exposure to cold objects. A subungual reddish-blue papule was noted. The second case is a 35-year old male with a 2-year history of solitary bluish papule on the right thigh with severe pain upon touch. Pressing with a pinhead and cold-sensitivity test elicited pain in both cases. Dermoscopy of the second case showed a multicolored structureless pattern consisting of a purple center surrounded by whitish and brown areas. A soft tissue mass on the first digit of right hand was noted in X-ray of the first case. Surgical excision was done on the first case. Skin punch biopsy was done on second case. Histopathology in both cases revealed nodules in the dermis composed of blood vessels lined by normal endothelium and surrounded by uniformly round cells with pale eosinophilic cytoplasm, clearly defined cell margins and central nuclei. These findings were consistent with a diagnosis of glomus tumor. No recurrence of lesions was noted.
Conclusion: Glomus tumor presents as reddish-blue papule(s) with pain, sensitivity to cold and pinpoint tenderness. It commonly affects subungual areas. Extradigital locations may be involved. Dermoscopy is helpful to establish the diagnosis. Imaging may be necessary to determine location and extent of the tumor. Routine histopathology is usually adequate to validate the clinical and dermoscopic diagnosis. Complete excision results in cessation of pain and decreased risk of recurrence. Malignant glomus tumor is rare.
Dayrit, J., Bintanjoyo, L., Acosta, J. & Villamin, CA (2017). Touch me not: a report on 2 cases of glomus tumors showing variation in clinical presentation. Journal of the Philippine Dermatological Society, 26(2), 81-83.
Glomus tumor, nails, dermoscopy
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