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Sir,
45 years old female with no significant past medical or family history that was seen due to contact dermatitis on her left arm, during her physical examination was observed to have onychophaty on her right toenails, pincer nails was observed on big and second toenail (Figs. 1 and 2), dermatoscopic view of the pincer nails (Fig. 3 [See PDF]). The diagnosis pincer nails was done, the patient didn´t return to the another new.
Figure 1 [See PDF]
Macroscopic view of pincer nail.
Figure 2 [See PDF]
Close up of pincer nail on second and big toenail.
Figure 3 [See PDF]
Dermatoscopic view of pincer nails.
The pincer nail is a dystrophy of the nail probably produced by an enlarged base of the distal phalanx, thus producing an over curvature of the nail along its long axis. It is a frequent condition on toes; other names for this condition are: incurved nails, unguis constringes, trumpet nail or omega nail.
Usually, in toenails, the nail plate curvature is more pronounced than in fingernails, but when this curvature becomes excessive, the lateral border of the nail plate inserts itself into the soft tissue of the lateral grooves pinching the nail bed.
The lateral nail plate margin sinks into the epidermis thus producing granulation tissue, as in ingrown nail [1].
There are three clinical types of pincer nail depending on its morphology: trumpet nail deformity (Figs. 4a - 4e), tile nail (Figs. 5a and 5b) and plicated nail (Figs. 6a - 6c) [1].
Figure 4 [See PDF]
(a- e) Different types of pincer nails.
Figure 5 [See PDF]
(a and b) Tile nails.
Figure 6 [See PDF]
(a-c) Plicated nails.
Trumpet nail deformity, the most common form of pincer nail, is characterized by the nail plate lateral borders rolling under itself, taking a cylinder or omega shape, the transverse diameter of the nail is decreased and the distal border is lifted up by the traction exerted on the distal dorsal tuft, as a result the nail bed gets pinched. The plicated nail presents moderate convexity with its lateral edges sharply turned down to form a vertical sheet; then, the nails lateral edges press into the lateral nail grooves. The tile nail deformity is frequently seen in tall young...