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Note what signs you see.
I (W. Wertelecki, M.D.) see a large hallux (first toe) and post-surgical evidence of a resection of the second toe.
PERSPECTIVE: macrodactyly can impact all digits and generally is a manifestation of genetic mutations, thus is congenital. Instances of isolated macrodactyly to a particular to a few digits are a sign that signals the possibility of a peripheral neuroma triggering the ectopic excessive growth.
Please also see the gallery of NF1 signs and other images of this patient.