Parrot Beak Nail: Case Report and Review of Parrot Beak Nail Dystrophy

Abstract

Parrot beak nail dystrophy is an excessive forward curvature of the nail plate that can affect both fingernails and toenails. Few cases have been reported since its original description in 1971; however, the incidence is estimated to be 2.5% in healthy individuals. Although the pathogenesis has not yet been established, parrot beak nail has been associated with chronic crack cocaine use, congenital bone or soft tissue abnormalities, other nail dystrophies, peripheral neuropathy, systemic sclerosis, and trauma to the nail. We describe an 86year-old man with dementia and neuropathy who presented with an unperceived parrot beak nail of his left fourth toenail and concurrent onycholysis of his left great toenail. He had stopped visits with his podiatrist for nail care, which fostered the growth of these nail dystrophies. Our patient's parrot beak nail was successfully treated with nail clipping and regular nail maintenance to prevent its recurrence. The associated conditions, etiologies, and treatment of parrot beak nails are discussed.

Parrot beak nails: a Latin American case series

“… 1 Authors who support this theory claim the over curvature seen in PBN can be temporarily corrected after submerging the affected nail in water for some minutes, since it would overcome those hydrophobic interactions. 2 An injury could be the main cause, as in the present study’s second and third cases. It would generate a chronic imbalance of growth and alter the content of hydrophobic phospholipids, leading to a pronounced longitudinal curvature.…”

“…Other case series have shown that 31% of patients with systemic sclerosis can present this nail dystrophy. 2 , 3 This deformity has been found in 11 to 89-year-old patients, without sex predominance. We found nine articles reporting this clinical finding, with a total of 78 patients ( Table 1 ).…”

“…Neuropathy-associated cases were previously reported by Forouzan et al, who described a patient unaware of his toenail elongation, due to an androgen deprivation therapy-induced peripheral neuropathy. 2 Other neuropathy-associated cases described by Chen et al include diabetes and spinal stenosis-induced neuropathy. The present study’s first patient had leprosy neuropathy; an association not described to the date in the revisited literature.…”

“…Diagnosis is clinical, a semiological aid consists in soaking the nail in water for 30 minutes, which would temporarily correct the deformity. 2 …”