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Retronychia is a frequently misdiagnosed nail disorder characterized by proximal ingrowth of the nail into the proximal nail plate. Often presenting with chronic paronychia, retronychia is commonly misdiagnosed and treated ineffectively with antimicrobials. The main cause is repeated micro-trauma to the affected nail, therefore a thorough history of exposures and insults to the toenail is crucial in identifying the cause of this nail abnormality. Herein, we describe a case of a UPS employee who presented with a painful nail after dropping a package on her foot that was unresponsive to medical treatment for 2 years. This case highlights the importance of taking a thorough history and physical examination for diagnosing retronychia.

Congenital curved nail of the fourth toe represents an unusual deformity in which the nail of the fourth toe curves in a plantar direction. It is unknown why only this toe is affected; however, the initial descriptions suggest that this is a mesodermal defect. We describe a case of congenital curved nail of the fourth toe associated with bifid uvula. There are only 2 reports mentioning the association of this nail abnormality with cleft palate and/or lip. In our patient, there was an association with bifid uvula that is considered a minor form of palatine fissure. There seems to be an association of congenital curved nail of the fourth toe with cleft palate to different degrees; however, the pathogenesis of the deformity remains unknown.