Pincer nail deformity - Nail and Distal Digit
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Synopsis
The condition is more common in women and typically presents in the fifth decade. It occurs frequently on the toes, particularly the great toenails, and only rarely on the fingers. Pain is a common complaint and can be intense. In time, the lateral nail plate edges dig into the lateral grooves and progressively pinch the nail bed. Ultimately, the lateral borders of the nail plate join together leading to the so-called trumpet nail.
Pincer nail may be inherited or acquired. Acquired cases may be caused by osteoarthritis, ill-fitting shoes, subungual tumors, psoriasis, onychomycosis, arteriovenous fistula of the forearm, Kawasaki disease, beta blockers, and paraneoplastic sign. Poorly fitting shoes is the most commonly cited cause. Inherited pincer nail is rare, but an association has been reported with Clouston syndrome. In the hereditary cases, the pincer nail is typically bilateral and involves the fingernails.
Codes
ICD10CM:L60.8 – Other nail disorders
SNOMEDCT:
247486000 – Pincer nail deformity
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Onychocryptosis (ingrown nail)
- Exostosis
- Onychomycosis
- Psoriasis
- Pachyonychia congenita
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:06/30/2019
Last Updated:07/01/2019
Last Updated:07/01/2019
Pincer nail deformity - Nail and Distal Digit