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Notes: Case 1 A 50-year-old woman presented to our Dermatology Department with a 2-month history of edema and pain in the third right toe. She had a past history of common warts, chronic venous insufficiency, fibromyalgia, and noninsulin-dependent diabetes mellitus. No previous trauma to the toe could be recalled.Physical examination revealed digital clubbing, minimal lateral onycholysis, and subungual keratosis (〈link href="#f2-1"〉Fig. 1). Mycologic examinations (KOH and culture) were negative on two separate occasions and the X-ray revealed only soft tissue augmentation without evidence of bone involvement. A nail biopsy was performed with the clinical diagnosis of glomus tumor vs. neuroma vs. neurilemmoma. Histologic sections showed a dermal unilocular cyst lined by an epidermis-like epithelium with a granular cell layer, filled with laminated orthokeratin (〈link href="#f2-2"〉Fig. 2); a diagnosis of subungual epidermoid cyst was established. The patient experienced recurrent pain 1 month after surgery, and a re-excision was performed. The second biopsy showed only fibrous collagen bundles consistent with scar tissue. Intralesional steroid was injected to the site of the scar, and the patient is currently free of pain.〈figure xml:id="f2-1"〉1〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD1254-3:IJD_1254_f2-1"/〉Digital clubbing of the third finger. There is also lateral onycholysis and subungual keratosis〈figure xml:id="f2-2"〉2〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD1254-3:IJD_1254_f2-2"/〉Hyperkeratosis and, in the dermis, a subungual epidermoid cyst. The wall is composed of stratified squamous epithelium, and the cyst is filled with laminated orthokeratin Case 2 A 40-year-old woman presented to our Dermatology Department with a 5-year history of throbbing pain in the first right toe. Her medical history was only relevant for syringomas and onychomycosis, and no traumatic event was recalled.Physical examination revealed a slight increase in volume in the lateral aspect of the toe. There were no changes in the skin. Palpation increased the painful sensation. With the presumptive diagnosis of neuroma, a nail biopsy was performed, showing a subungual epidermoid cyst. The patient is currently free of pain 15 months after surgery.