A Nonhealing, Painful, Exophytic, Eroded Nodule on the Left Fifth Toe.

Abstract

A 34-year-old male with no significant past medical history presented for evaluation of a 15-year, growing, 8-mm, red eroded nodule with collarette of scale on his left fifth toe that appeared after a distant history of trauma. On initial examination, the lesion was clinically suspected to be a pyogenic granuloma. At this visit, a shave biopsy was performed revealing a soft white subcutaneous mass that was easily removed from the surrounding dermis. Histology revealed a soft-tissue mass with biphasic proliferation of elongated spindle cells with tapered nuclei occurring in compact cellular foci with palisading (Antoni A) and fewer paucicellular myxoid foci (Antoni B) consistent with a schwannoma. Schwannoma of the foot is rare, with the dorsum or interdigital space of the foot being the least reported manifestation on the foot. Podiatrists and dermatologists alike may consider schwannoma of the foot when evaluating chronic, non-healing, painful nodules, and papules.