Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin Toenails

Introduction: Congenital malalignment of the great toenail (CMGT) is characterized by deviation of the nail plate due to rotation of the nail matrix. CMGT may be complicated by secondary retronychia. Case Presentation: We report a case of twin 14-year-old females who presented with CMGT with seconda...

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Bibliographic Details
Published in:Case reports in dermatology Vol. 17; no. 1; pp. 157 - 164
Main Authors: Forman, Carrie A., Desir, Noelle, Ong, Michael M., Lipner, Shari R.
Format: Journal Article
Language:English
Published: Switzerland S. Karger AG 03.04.2025
Karger Publishers
Subjects:
Case and Review
Case report
Congenital malalignment of the great toenail
Nail disorders
Retronychia
Medical dermatology
Pediatric dermatology
ISSN:1662-6567, 1662-6567
Online Access:Get full text
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Summary:Introduction: Congenital malalignment of the great toenail (CMGT) is characterized by deviation of the nail plate due to rotation of the nail matrix. CMGT may be complicated by secondary retronychia. Case Presentation: We report a case of twin 14-year-old females who presented with CMGT with secondary retronychia with no clear inciting event. Physical examination demonstrated lateral deviation of the great toenails with yellowed, thickened, and layered nail plates, consistent with a diagnosis of CMGT with secondary retronychia. The patients were advised to make relevant lifestyle changes and treated with clobetasol proprionate 0.05% ointment to use on all toenails daily for 3 months, with 1 week off per month, under occlusion. Conclusion: We hypothesize that both genetic and environmental factors likely contributed to the development of CMGT with secondary retronychia in these twins. Increased awareness and recognition of this underdiagnosed condition, particularly in the pediatric population, is important for timely and effective management.
Bibliography:ObjectType-Case Study-2
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ISSN:1662-6567
1662-6567
DOI:10.1159/000545462