ACQUIRED MALALIGNMENT - A COMPLICATION OF LATERAL LONGITUDINAL NAIL BIOPSY

We report the development of malalignment of the nail following latera l longitudinal biopsy of the nail unit in seven subjects, The lateral biopsies were in excess of the routine 3 mm diagnostic biopsy performe d for investigation of a nail dystrophy, being indicated for excision of focal pathology, Deviation of the distal nail towards the side of e xcision might be accounted for by one or both of two mechanisms, First , the matrix might become skewed by the unilateral loss of a ligamento us structure extending from the lateral ligament of the distal interph alangeal joint. Second, there may be a reduction of embedding of nail in the lateral nail fold on the operative side in spite of a thorough lateral nail fold reconstruction. This reduction may result in an unop posed inward force from the remaining nail fold.