further delineation of pseudotrisomy 13 syndrome a case without polydactyly we report on a baby with holoprosencephaly median cleft lip cardiac and genital anomalies normal upper limbs and a 46xx karyotype we also reviewed 22 karyotypically normal cases whose clinical features resembled trisomy 13 syndrome and compared them with the case we present the problem of variable expression of the pseudotrisomy 13 syndrome versus genetic heterogeneity is illustrated treatment of subungual myxoma preserving the nail matrix a case report subungual myxomas are uncommon benign expansile lesions that club the fingertip traditionally the nail matrix is incised which results in permanent nail deformity this report describes a midlateral approach that not only spares the nail apparatus but demonstrates that the nail can remodel even if a void is left under the nail matrix after excision of the tumor the histologic examination of the tumor is described