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Our Dermatol Online. 2012; 3(1): 57-60
Date of submission: 20.02.2011 / acceptance: 22.04.2011
Conflicts of interest: None


Patricia Chang

Dermatologist Hospital General de Enfermedades IGSS y Hospital Ángeles Guatemala

Corresponding author: e-mail:

How to cite an article: Chang P. Dorsal Ungual Pterygium. Our Dermatol Online 2012; 3(1): 57-60.

Pterygium unguis also known as Dorsal pterygium [1] forms as a result of scarring between the proximal nail fold and matrix, with the classic example being lichen planus, though it has been reported to occur as a result of sarcoidosis and Hansen’s disease [2]. Is a wing-shapes scar and always irreversible, consist of a gradual extension of the proximal nail fold over the nail plate which becomes fissurated because of the fusion of the proximal nail fold epidermis to the nail bed, its split portions progressively decrease in size as the pterygium widens, leaving two small nail remmants if the pterygium is central but when the involvement of the matrix and nail bed is complete produces onychatrophy. The causes of dorsal pterygium are: congenital, bullous dermatosis (cicatricial pempghigoid, Stevens Johnson syndrome), burns, dyskeratosis congenital, graf-versus host disease, lichen planus, onychotillomany, radiodermitis, Raynaud´s disease and peripheral vascular disease. Lichen planus is the most common cause of dorsal pterygium [3]. Can affect finger and toenails, the most common affected are the big toenails.
Figure 1. Dorsal ungual pterygium
Figure 2. Dorsal ungual pterygium
Figure 3-8. Dorsal ungual pterygium
Figure 9. Dorsal ungual pterygium
Figure 10. Dorsal ungual pterygium
Figure 11. Dorsal ungual pterygium
Figure 12. Dorsal ungual pterygium
Figure 13. Dorsal ungual pterygium
1. Freedberg: Fitzpatrick’s Dermatology in General Medicine. (6th ed.), McGraw-Hill 2003. 2. James, William, Berger, Timothy, Elston, Dirk: Andrews’ Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders 2005. 3. Baran R, Dawber RPR, Tosti A, Haneke E: A text Atlas of nail disorders Martin Dunitz London 2001:84-87.

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