A 28-year-old man baffled doctors recently when he complained of discomfort and presented a “strange growth” that had emerged from the middle fingernail of his left hand. The Daily Mail shared “fascinating images” on Wednesday that show what appears to be a smaller finger, complete with its own fingernail, growing out from underneath the cuticle of the unidentified Pakistani man’s middle finger.
The man’s “extremely rare” case of an accessory nail surfaced online in the International Journal of Surgery Open earlier this year and is only the fourth case ever published in medical literature, according to IJS Open. Contents of the man’s case study are also published in Science Direct and share that most cases of double nail go unnoticed and are only sometimes “accidentally” discovered by patients who are feeling pain and discomfort.
According to the Daily Mail, the Pakistani man, who’s a resident of Bahawalpur, a city located in Eastern Pakistan in the Punjab province, reportedly showed up at an outdoor medical camp complaining of pain from the hard “bizarre lump” when he performed manual work. The man also reportedly was concerned about the cosmetic aspect of having what appeared to be another whole, but much smaller, finger growing out of the cuticle of his middle finger.
“They explained how he complained of pain when he was working – but it is unsure what his job was. He also showed ‘cosmetic concerns.'”
After first unsuccessfully visiting his general practitioner for a diagnosis, the man reportedly then sought help from experts at the Bahawal Victoria Hospital’s outdoor clinic. According to the aforementioned case study published in IJS Open, a specialist surgeon determined through an exam and a digital x-ray that the man’s left middle finger showed no other signs of past surgery, infection, or other “unusual findings,” aside from the “strange growth.”
Science Direct writes that the man’s middle fingernail of his left hand did appear to be “abnormally wide” with a depression running lengthwise through the center of the nail, which is also where the accessory nail was growing. Doctors were left “baffled,” according to the Daily Mail, which also noted that the man’s cuticle protruded slightly where the “bizarre lump” was growing from underneath the cuticle.
The Daily Mail also noted that doctors finally determined through laboratory testing that the “tiny” extra growth was simply made of tough nail protein called keratin. An article on Gizmodo that was published on Tuesday shows the man’s extra fingernail — after it was surgically removed under local anesthesia — placed “next to a syringe for scale.”
The Daily Mail shared that the small growth only measured less than one centimeter after it was removed and also shared that the man’s case of a double nail is actually “more common than thought” after a study late last year showed that several cases of double toenails have surfaced worldwide. According to the previously-mentioned Gizmodo article, additional nails, also known as “auxiliary nails,” are especially common on pinky toenails and are typically genetic.