A rare case of familial malalignment of the great toenails

We report a 27-year-old male presenting with malalignment of the great toenail, a nail disorder characterised by lateral deviation of the nail plate. This case presented a familial clustering of the condition and the cyclic nature of nail shedding. Clinical examination revealed significant thickening, increased curvature, discolouration and lateral deviation of both great toenail plates significantly impacting the patient’s quality of life. There were no predisposing factors including any history of trauma, systemic illness or fungal infection. This case underscores the importance of considering familial predisposition in the evaluation and management of malalignment of great toenails, highlighting the need for further research into its genetic underpinnings.