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Onychogryphosis

Helenka Stone, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Onychogryphosis describes claw-like hypertrophy and thickening of the entire nail plate, involving most commonly the great toe, leading to severely distorted, brownish, spiraled nail...

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 with 40% urea (3)[A]

  • Trimming by a podiatrist (3)[B]

  • Avulsion of the nail plate with surgical destruction of the matrix with phenol or the CO2 laser

  • Antifu...

ONGOING CARE

PATIENT EDUCATION

  • Educate the patient to avoid:

    • Tight-fitting footwear

    • Nail polish

  • Nails should be kept trimmed.

PROGNOSIS

  • Onychogryphosis has an excellent prognosis; however, treatment must be...

REFERENCES

1
Betti S, Bassi A, Prignano F, et al. A lifelong onychogryphosis. G Ital Dermatol Venereol.  2009;144(4):502–503. [View Abstract on OvidMedline]
2
Nath AK, Udayashankar C. Congenital ony...

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.

  • Yang TH, Tsai H...

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 podiatric care is essential to control this c...

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