Hyperkeratosis and Discoloration of the Toenails in an 8-Year-Old

An 8-year-old boy with no pertinent past medical history presented to the dermatology clinic with a complaint of an abnormal appearance and occasional pain in both great toenails. His mother reported that the nail changes had been present since the patient was born. The child had undergone surgical removal of both toenails 2 years prior, however, the nails grew back with a similar appearance. The patient denied any recent trauma to his toenails. No other family members were known to have a similar condition.

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