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Onychogryphosis

Benjamin Ihms, DO and Linda Lau, MD, FAAFP Reviewed 06/2019
 


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

MEDICATION

First Line

  • Periodic clipping by PCP

    • With 40% urea (2)

    • May be pretreated with liquid nitrogen (4)

  • Trimming by a podiatrist (2)

  • Avulsion of the nail plate with surgical destruction of t...

ONGOING CARE

PATIENT EDUCATION

  • Nails should be kept trimmed.

  • Avoid tight-fitting footwear.

    • Repetitive trauma worsens condition.

  • Avoid nail polish.

    • May cause moisture trapping

PROGNOSIS

  • Onychogryphosis ha...

REFERENCES

1
Nath AK, Udayashankar C. Congenital onychogryphosis: leaning tower nail. Dermatol Online J.  2011;17(11):9. [View Abstract on OvidMedline]
2
Galeone M, Scarfì F, Arunachalam M, et al. R...

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;43(4):583–586. [View Abstract...

CODES

ICD10

L60.2 Onychogryphosis 

ICD9

703.8 Other specified diseases of nail 

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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