Photo Quiz

Mass Connected to a Newborn's Finger


Am Fam Physician. 2017 Mar 1;95(5):327-328.

A black male infant was born at 40 1/7 weeks estimated gestational age via primary cesarean delivery because of failure to progress. The Apgar score was 9 at one and five minutes. A mass was noted on his right hand.

During the prenatal period, his mother was treated with valacyclovir (Valtrex) for herpes simplex virus infection. Intrauterine ultrasonography showed left kidney pyelectasis. The newborn's older sibling had a similar finding at birth.

Physical examination of the newborn revealed a small, pedunculated mass that was attached by a fine stalk to the ulnar aspect of his right fifth digit (Figure 1). The mass was initially green but turned black at two hours of life. The remainder of the physical examination was unremarkable, with no other cutaneous growths or malformations noted.

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Figure 1

Figure 1


Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?

A. Accessory (supernumerary) digit.

B. Acquired digital fibrokeratoma.

Address correspondence to Elizabeth Seiverling, MD, at Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.


show all references

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This series is coordinated by John E. Delzell, Jr., MD, MSPH, Assistant Medical Editor.

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