Unilateral pterygium inversum unguis

Pterygium inversum unguis is a nail abnormality in which the distal aspect of the nail bed/hyponychium is adherent to the ventral surface of the nail plate, resulting in obliteration of the distal groove. We present a 50-year-old man who developed this abnormality on his right fingers and toes after a stroke that resulted in paresis of his right side. Unusual features of this case include the association with a neurologic disorder, assymetric distribution, involvement of toes as well as fingers, and occurrence in the male gender.