An Uncommon Cause of Pincer Nail

Pincer nail is a deformity characterized by excessive transverse curvature of nail, progressively increasing along its longitudinal axis. The curvature is greatest at the distal end, leading to an ingrown nail, producing pain, discomfort, and significant cosmetic alteration. It is a severe variant of ingrown nail, often attributed to causes such as anatomical variation of nail plate axis, tight footwear, gait abnormalities, and so on. Correspondingly, its management involves the removal of the lateral ingrowing nail plate or the lateral hypertrophic nail folds. We report a young male who presented with symptomatic pincer nail deformity. However, on exploration there was a midline onychomatricoma, leading to the thickening of the central part of the nail plate, causing incurving of the lateral nail plate and discomfort. The report serves to highlight the need for a comprehensive evaluation of pincer nails, to assess for matrix disease as well, because the surgical approach will differ accordingly.