The digital disturbances pictured are examples of an uncommon cutaneous growth which causes concern either by the production of local discomfort or by disturbance of the normal pattern of nail growth. These cystic lesions occur most commonly on terminal parts of the fingers, but they can also be found on other areas of the hands, or occasionally on the feet.
Simple observation is usually all that is necessary for diagnosis of these cutaneous myxoid cysts. In most instances, a firm, single, fluctuant nodule is visible and palpable (Fig 1). Sometimes the cyst itself is not apparent, but the resultant disturbance in nail-forming epithelium can be recognized by a furrow in the nail plate (Fig 2). A clear, thick, syrup-like material can often be expressed from the incised lesion.
These lesions were once thought to be cysts which extended from a joint capsule or tendon sheath into the dermis (and therefore