Certified Hand Therapist (CHT) Practice Exam

Which painful lesion is common in the subungual fingertip and sensitive to cold?

1. Inclusion cyst

2. Glomus tumor

3. Xanthoma

4. Schwannoma

The correct answer is: Glomus tumor

The glomus tumor is a painful lesion that frequently occurs in the subungual fingertip area and is characterized by its sensitivity to cold. This condition is a benign tumor composed of a specialized type of neuromuscular tissue, which is involved in the regulation of temperature. The glomus body contains arteriovenous connections that help regulate blood flow and thermoregulation, which explains why lesions are particularly painful when exposed to cold temperatures. Patients often report localized pain that can be quite severe, especially when the area is cold or under pressure. The classic presentation involves a history of increased pain following cold exposure, which helps differentiate it from other types of lesions. Additionally, the typical location under the nail plate makes it a frequent consideration in cases of fingertip pain. In contrast, other types of lesions listed, such as inclusion cysts, xanthomas, and schwannomas, do not typically present with the same acute sensitivity to cold, nor are they commonly found in the specific area of the subungual fingertip. Each has different characteristics and clinical presentations that aid in their differentiation from glomus tumors.