Periungual fibromas are rare benign dermatologic lesions that may be acquired or associated with tuberous sclerosis or von Recklinghausen's disease. Periungual fibromas may place excessive pressure on the nail matrix, resulting in the potential for extensive nail pathologic conditions and pain. Radical surgical excision of the lesion is the preferred treatment in symptomatic cases. The case of such a foot lesion occurring in an elderly man, including histopathologic analysis of the excised lesion, is detailed here.