Digital Myxoid Cyst

A 63-year-old man complained about an asymptomatic “bump” on a finger. The lesion had been present and slowly growing at least 3 months.

Key points: Physical examination disclosed a solitary, minimally tender, 3.5-mm translucent dark pink nodule located just behind the nail on the left third digit. This is the classic presentation of a digital myxoid cyst.

Treatment: Because of the typical communication of such cysts with the underlying interphalangeal joint space, they are best removed by a hand surgeon. However, they often resolve spontaneously or following repeated removal of the gelatinous contents via a tiny needle puncture.

Note: This lesion puts pressure on the underlying nail matrix, producing defect in the nail plate. In this case, that is manifest by a narrow, longitudinal depression in the nail.