Abstract
Onychopapilloma is a benign tumor of the nail unit characterized by broad clinical variability, which frequently delays diagnosis. It typically presents as longitudinal erythronychia, melanonychia, subungual hyperkeratosis, or a distal nail mass. We report a 65‐year‐old woman with a chronic single‐digit nail lesion initially misdiagnosed as onychomycosis. Dermoscopy revealed distal hyperkeratosis and a subungual mass. Histopathological examination confirmed onychopapilloma, and complete surgical excision resulted in symptom resolution. This report underscores the importance of distinguishing this entity from malignant nail tumors and highlights the diagnostic value of dermoscopy and histopathology. Early recognition may prevent diagnostic delay and unnecessary treatments.