Congenital curved nail of the fourth toe--three different clinical presentations.

A congenital curved nail of the fourth toe (NIM 219070) is a rare nail deformity with no other associated abnormalities. Three patients with this congenital anomaly are reported here. Radiologic examination in all three revealed distal symphalangism of the fourth toes bilaterally. The clinical manifestations in these patients included white discoloration of the proximal nails and hyperkeratotic tylosis.