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Onychogryphosis

Benjamin Ihms, DO Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Onychogryphosis describes claw-like hypertrophy and thickening of the entire nail plate leading to severely distorted, brownish, spiraled nails creating the appearance of a ram’s hor...

DIAGNOSIS

HISTORY

  • Onychogryphosis is easily detected in the later stages when the changes are severe; however, in the early stages of mild hypertrophy, the diagnosis may be difficult to determine.

  • Often...

TREATMENT

GENERAL MEASURES

Goal of treatment is to prevent progression of disease and avoid complications such as ingrown nails, infection of the nail bed, and, rarely, subungual gangrene  (1). 

MEDICATION

ONGOING CARE

For conservative care, follow-up appointments every 6-12 months for repeat nail trimming are warranted. 

PATIENT EDUCATION

  • Nails should be kept trimmed.

  • Avoid tight-fitting footwear.

    • Repetiti...

REFERENCES

1
Ko D, Lipner SR. Onychogryphosis: Case Report and Review of the Literature. Skin Appendage Disord. 2018;4(4):326-330.
2
Westerberg  D, Voyack  M. Onychomycosis: curre...

ADDITIONAL READING

  • Gürbüz  K, Ozan  F, Kayali  C, et al. Total matricectomy and V-Y advancement flap technique in the treatment of onychogryphosis. Dermatol Surg.  2017...

CODES

ICD10

L60.2 Onychogryphosis 

SNOMED

52897009 Onychogryposis 

CLINICAL PEARLS

  • A clinical diagnosis can be made by from the presentation of onychogryphosis: thickened, opaque, brown, laterally displaced nail.

  • Continued regular trimming with periodic follow-up is e...

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