Buttars Benjamin, Scott Steven Gates, Glinka Danielle, Daniel C Ralph, Brodell Robert T, Braswell Mark A
Alabama College of Osteopathic Medicine, Dothan, Alabama, USA.
University of Mississippi Medical Center, Jackson, Mississippi, USA.
Skin Appendage Disord. 2022 Jan;8(1):8-12. doi: 10.1159/000518477. Epub 2021 Sep 1.
Congenital malalignment of the great toenail (CMGT) is an idiopathic deviation of the nail apparatus. CMGT predisposes patients to recurrent stress forces, microtrauma, and secondary complications. The purpose of this study was to review the current published photographs to determine the relationship between variants of CMGT and the disappearing nail bed (DNB).
A search in PubMed and Google using the terms congenital malalignment of the great toenail, disappearing nail bed, and lateral nail deviation was performed. Of the 53 photographs found in a total of 35 articles, 23 were disqualified due to low picture resolution or poor angle. The remaining 30 photographs were evaluated. Pure nail malalignment with associated dystrophy and DNB was found in 22 of 30 photographs. Four of 30 cases demonstrated pure deviation of the distal phalanx, with nail dystrophy but minimal DNB. The remaining 4 cases demonstrated a combination of toe deviation and nail unit deviation with varying degrees of DNB.
DNB was associated with all forms of pure CMGT. Moreover, a variant of malalignment of the distal phalanx was noted in 8 photographs. This has potential implications for further studies and treatment to correct secondary complications.
先天性拇趾趾甲排列不齐（CMGT）是甲器的特发性偏差。CMGT使患者易遭受反复的应力、微创伤及继发性并发症。本研究的目的是回顾当前已发表的照片，以确定CMGT的不同变体与甲床消失（DNB）之间的关系。
在PubMed和谷歌上使用“先天性拇趾趾甲排列不齐”“甲床消失”和“趾甲外侧偏斜”等术语进行了检索。在总共35篇文章中找到的53张照片中，23张因图片分辨率低或角度不佳而被排除。对其余30张照片进行了评估。在30张照片中的22张中发现了伴有相关营养不良和DNB的单纯趾甲排列不齐。30例中有4例表现为远节指骨单纯偏斜，伴有趾甲营养不良但DNB轻微。其余4例表现为趾偏斜和甲单元偏斜的组合，伴有不同程度 的DNB。
DNB与所有形式的单纯CMGT相关。此外，在8张照片中发现了远节指骨排列不齐的一种变体。这对进一步研究和治疗继发性并发症具有潜在意义。
