pterygium inversum unguis - this condition is similar to the pterygium of the proximal nail fold as seen in lichen planus
occurs when the volar skin near the hyponychium adheres to the nail plate - this eliminates the distal nail groove and progresses proximally to the nail bed
pterygium inversum unguis occurs as a congenital form and an acquired form
acquired form is seen most commonly with systemic connective tissue diseases
especially seen in progressive systemic sclerosis and systemic lupus erythematosus
involvement may be with the entire nail or just a portion
one or more nail units may be involved
skin in the distal nail unit becomes atrophic
changes are secondary to vascular flow occlusion which creates distal hypoxaemia
Reference:
Zaiac MN, Daniel CR. Nails in systemic disease Dermatologic Therapy 2002;15 (2); 99–106.
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