Acute pancreatitis: an unusual complication of dengue fever.

without significant bone anomalies was unlikely as child did not have affected relatives. There are wide variety of congenital or hereditary disorders in which there is total or partial absence of nails. These disorders are usually associated with other major congenital anomalies. Fetal phenytoin syndrome occurs approximately 7 to 10% of all babies exposed to phenytoin during pregnancy. The features of this disorder include craniofacial abnormalities (hypertelorism, epicanthic folds, broad depressed nasal bridge, long philtrum, low hair line, abnormal ears), prenatal and postnatal growth deficiency, hypoplastic nails of fingers and toes, distal phalangeal hypoplasia and mental retardation. Other findings occasionally associated include cleft lip and cleft palate, cardiac malformations, microcephaly and ocular defects.1,2 Absence or hypoplasia of nails is more common than any other congenital anomaly. Nail abnormalities are associated with increased maternal serum phenytoin concentration.3 Since the teratogenic effect of the drug is dose dependent, it is prudent to monitor drug levels regularly.