Unilateral nail and toe nail dystrophy in a case of hemiplegia: A rare presentation of reflex sympathetic dystrophy

Sir, Chronic regional pain syndrome (CRPS) is a disabling, complex, poorly understood neurovascular disorder and has two subtypes. Reflex sympathetic dystrophy (RSD) (type 1) is seen following noxious events, and type 2 is seen after definitive peripheral nerve damage. Both have characteristic hyperalgesia and continuing pain. Nail changes such as leukonychia, Beau’s lines, nail-fold swelling, clubbing, acute paronychia, dystrophy and trachonychia are seen.[1] Herein, we report a case of CRPS type 1 following a cerebrovascular accident in a male who presented with pain in the left half of the body and dystrophy of all fingers and toenails.