LAUSR

There are very few papers in dermatological literature devoted to the features of the nails of healthy babies born at term. Consequently, the team of TOURS University (Tours, France) should be congratulated for their excellent idea and the quality of the work presented here. Some findings are surprising at the age of the newborns selected by the authors (3.6 1.2 days): fingernails had an oval shape (71.1%) or a flat curvature (63.5%). The shape of the nails were triangular (50%), and koilonychia was noted in 32.7% of infants. What I also found amazing was that onychoschizia was seen in 28.8% of the newborns, despite the absence of microtrauma at this age! The authors were fortunate as they did not find any of the abnormalities which can be observed at birth, for example malalignment of the big toenails, hypertrophic lateral nail folds and the rare congenital anonychia where usually, the distal phalanx is atrophic, or more often missing (no bone, no nail). Neither ectopic nail nor polydactyly was seen. All the newborns were free of congenital candidosis. Interestingly, nail patella syndrome can be diagnosed in neonates where nail anomalies are usually the only manifestation. Congenital onychodysplasia of the index fingers (Iso–Kikuchi syndrome) is observed at birth, and Y-shaped bifurcation of the distal phalanx is characteristic of the condition. Finally, one of the great advantages of this work is to teach dermatologists that the clinical nail description produced by the authors stays within the limits of the standard and lets parents heave a sigh of relief.