Double Nail of the Little Toe

Abstract

A rudimentary accessory or double nail of the little toe is not rare, although only described three times before. Most cases are accidentally detected and only few patients seek help because they have discomfort or pain. Some have a positive family history, but most patients cannot give any information concerning heredity. Clinically, the nail of the little toe is abnormally wide and is split or shows a longitudinal depression corresponding to a slight protuberance of the cuticle. Histopathology shows a complete though short nail. The treatment of choice is segmental excision of the entire accessory nail unit with mobilization of the lateral skin and primary suture.

Nail plate split of the fifth toenail

“…In the largest review to date of this condition, 2 completely distinct nail plates were rare, and findings were often symmetrical. 2 A quarter of cases in this series were more prominent on one side, 2 like our patient, with more subtle findings on the other foot ( Fig 2 ). This is often asymptomatic but can be tender due to compression of the lateral nail fold.…”

“…Excision shows all characteristics of a normal fifth toenail: proximal nail fold, matrix, and short nail bed. 2 Nail clipping for hematoxylin and eosin – Incorrect. Similar to answer choice A, there is no histologic abnormality of well-developed accessory toenails.…”

“…There have been reports that this is common in Han Chinese, 3 but additional reports have shown a broad range of races and ethnicities with this presentation. 2 Double fifth toenail diagnosis alone does not require a genetics evaluation. Radiograph – Correct.…”

Double nail of the second toe: A case report with sonographic and radiological correlation

“…2,3 Congenital double toenails may represent an incomplete form of polydactyly, with some of these cases associated with a Y-shaped bone abnormality in the underlying distal phalanx. [1][2][3] Polydactyly of the toes are divided into preaxial (hallux), postaxial (fifth toe), and mesoaxial (second to fourth toes), the latter being the rarest. Generally, polydactyly is isolated and can go unnoticed or manifest only with nail alterations.…”

“…However, segmental excision with electrocoagulation or phenol ablation of the nail matrix can be performed if the patient has pain or discomfort. [1][2][3] F I G U R E 1 Clinical image, longitudinal indentation of the second toenail plate…”