Onychocryptosis Affecting the Lateral and Medial Folds of Both Big Toes: A Rare Case Report and Review of the Literature

Abstract:

Onychocryptosis, otherwise known as ingrown toenails, is a disease of the nail apparatus frequently found in young adults characterized by pain, inflammation, and functional disability. It commonly affects the hallux and often associated with congenital anomalies of the nail folds and nail plates, medial rotation of the nail plates, and wearing of tight shoes. Though it is a common pathology among teenagers and young adults, onychocryptosis involving the medial and lateral folds of both big toes is very rare. Reported herein is a case of a 17-year-old undergraduate who presented to our facility with neglected chronically inflamed and infected ingrown toenails of both big toes of four years duration. On physical examination, he had hypertrophy of both lateral and medial nail folds of the two big toes with discharging purulent exudates. The right hallux was significantly bigger with bilateral hallux valgus deformity. He subsequently had partial nail resection and matricectomy after antibiotics treatment. This case report brings to the fore a very rare occurrence of onychocryptosis affecting both lateral and medial folds of both big toes and re-awakens the surgeons’ interest in their prevention and management.