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 w...

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Main Authors: Carrie A. Forman, Noelle Desir, Michael M. Ong, Shari R. Lipner
Format: Article
Language:English
Published: Karger Publishers 2025-04-01
Series:Case Reports in Dermatology
Online Access:https://karger.com/article/doi/10.1159/000545462
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author Carrie A. Forman
Noelle Desir
Michael M. Ong
Shari R. Lipner
author_facet Carrie A. Forman
Noelle Desir
Michael M. Ong
Shari R. Lipner
author_sort Carrie A. Forman
collection DOAJ
description 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.
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spelling doaj-art-ff269b6e99c844d3970e40a5c55dffc92025-08-20T03:09:48ZengKarger PublishersCase Reports in Dermatology1662-65672025-04-0117115716410.1159/000545462Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin ToenailsCarrie A. FormanNoelle DesirMichael M. OngShari R. Lipnerhttps://orcid.org/0000-0001-5913-9304 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. https://karger.com/article/doi/10.1159/000545462
spellingShingle Carrie A. Forman
Noelle Desir
Michael M. Ong
Shari R. Lipner
Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin Toenails
Case Reports in Dermatology
title Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin Toenails
title_full Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin Toenails
title_fullStr Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin Toenails
title_full_unstemmed Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin Toenails
title_short Congenital Malalignment of the Great Toenails with Secondary Retronychia: A Tale of Twin Toenails
title_sort congenital malalignment of the great toenails with secondary retronychia a tale of twin toenails
url https://karger.com/article/doi/10.1159/000545462
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AT michaelmong congenitalmalalignmentofthegreattoenailswithsecondaryretronychiaataleoftwintoenails
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