BACKGROUND. Occam's razor encourages ascribing a set of clinical findings to a single diagnosis. OBJECTIVE. To present a patient with a subungual wart and a glomus tumor of the same nail unit and to review the literature regarding these conditions. METHODS. We describe a 58-year-old female with a 2-year history of nail dystrophy and related symptoms that were initially attributed to verruca but recalcitrant to extensive therapies. RESULTS. Ultimately the persistence of her symptoms was found to be secondary to a subungual glomus tumor. CONCLUSION. Clinicians must maintain a high index of suspicion for the presence of multiple diagnoses to prevent the delay of appropriate management, particularly when symptoms do not respond to initial treatment.
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