Congenital Curved Nail of the Fourth Toe Associated with Oral Disorders

Abstract

Congenital curved nail of the fourth toe represents an unusual deformity in which the nail of the fourth toe curves in a plantar direction. It is unknown why only this toe is affected; however, the initial descriptions suggest that this is a mesodermal defect. We describe a case of congenital curved nail of the fourth toe associated with bifid uvula. There are only 2 reports mentioning the association of this nail abnormality with cleft palate and/or lip. In our patient, there was an association with bifid uvula that is considered a minor form of palatine fissure. There seems to be an association of congenital curved nail of the fourth toe with cleft palate to different degrees; however, the pathogenesis of the deformity remains unknown.

Congenital Curved Nail of the Fourth Toe with Subungual Hyperkeratosis

“…The association with other congenital anomalies, such as cleft lip, alveolus, and plate, has been reported. However, almost all patients had no other abnormalities [1]. Our patient had no other congenital abnormalities.…”

“…Eleven patients had a similar toe nail deformity in their family history. One patient had thumb polydactyly, and 3 had cleft lip and palate [1]. CNFT is characterized by a plantarly curved nail of the toe, which is parallel to the longitudinal axis of the distal phalanx.…”

“…Since then, a few cases have been reported [4][5][6][7][8]. Almost all reports were from Asian countries, such as Japan, Taiwan, and Korea, with only one case reported from Brazil [1]. In previous reports, there were more males than females (21 males and 5 females) and more bilateral cases than unilateral cases (22 and 5 patients, respectively).…”

“…Congenital curved nail of the fourth toe (CNFT) is a rare nail deformity, and it is rarely associated with other genetic anomalies [1]. Only a few cases have been reported, with limited description of surgical approaches [2].…”

Congenital curved nail of the fourth toe: Report of three cases and review of the literature

“…The deformity of the nail plate is thought to be secondary to the shortening of the terminal phalanx of the fourth toe, which is the base of the nail bed, and it is speculated that CNFT is due to a mesodermal rather than ectodermal abnormality 1 . However, CNFT is rarely associated with other congenital anomalies, and the relationship between CNFT and the previously reported anomalies such as cleft palate is unclear 1,5,6 . There were also reports of cases of CNFT with a family history, suggesting that it might be a hereditary disorder 1–3,6 …”