Dermatology: Practical and Conceptual


Image Letter  |  Dermatol Pract Concept 2019;9(4):4 271

Dermatology Practical & Conceptual

Case Presentation

A 4½-year-old boy presented with a delayed 

appearance of all fingernails and near 

absence of both thumbnails, present since 

birth, along with incomplete extension of 

the bilateral elbows. On examination, the 

bilateral thumbnails were hypoplastic and 

the index fingers of both hands showed 

tenting with triangular lunulae. Flexion 

deformity was noted at the bilateral elbows. 

A roentgenogram of the pelvis showed bilat-

eral iliac horns, while that of both knees 

showed absent patella. The rest of the exam-

ination was within normal limits. On the 

basis of the presence of bilateral iliac horns, 

triangular lunulae, webbing of elbow, and 

an absent patella (Figure 1, A-D), a diag-

nosis of nail-patella syndrome was made.

Teaching Point

Nail-patella syndrome presents with a 

classic tetrad of triangular lunulae, elbow 

pterygium, absent patellae, and posterior 

iliac horns. Dermoscopy aids in better visu-

alization of the triangular lunulae.

Nail-Patella Syndrome: A Classic Case
Sarita Sanke1, Taru Garg1, Rubina Jassi1, Apoorva Maheshwari1

1 Department of Dermatology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India

Key words: nail patella, elbow pterygium, iliac horns, dermoscopy

Citation: Sanke S, Garg T, Jassi R, Maheshwari A. Nail-patella syndrome: a classic case. Dermatol Pract Concept. 2019;9(4):271. DOI: 
https://doi.org/10.5826/dpc.0904a04

Accepted: July 3, 2019; Published: October 31, 2019

Copyright: ©2019 Sanke et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, 
which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: None.

Competing interests: The authors have no conflicts of interest to disclose.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Rubina Jassi, MD, DNB, MRCP (SCE), Department of Dermatology, Lady Hardinge Medical College, Shaheed 
Bhagat Singh Marg, New Delhi 110001, India. Email: jassi.rubina@gmail.com

Figure 1. Nail-patella syndrome collage showing (A) triangular lunula on dermoscopy, 

(B) bilateral posterior iliac horns, (C) bilateral elbow pterygium, and (D) absent patella. 

[Copyright: ©2019 Sanke et al.]

A

C

B

D