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Onychogryphosis
*Corresponding author: Shikha Bansal, Department of Dermatology and Sexually Transmitted Diseases, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. findshikha@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Kuchana P, Bansal S, Palanisamy M. Onychogryphosis. J Onychol Nail Surg. doi: 10.25259/JONS_37_2024
CASE DETAILS
A 46-year-old male presented with a 10-year history of progressive thickening, abnormal growth, and brownish discoloration affecting the left second toenail. He reported persistent difficulty in trimming the nail, with recurrent regrowth exhibiting similar deformity. The patient had no co-morbidities. Clinical examination revealed marked thickening, opaque yellow-brown discoloration, elongation, increased curvature and medial deviation of the left second toenail [Figure 1]. Direct microscopy of nail clippings treated with 40% potassium hydroxide was negative for fungal elements. Based on the history and clinical examination, a diagnosis of onychogryphosis was established.
- Clinical image showing an opaque, yellow-brown thickening of the nail plate, elongation, increased curvature, and deviation of the left second toenail. Other toenails are normal.
DESCRIPTION
Onychogryphosis is characterized by marked thickening, yellow-brown discoloration, elongation, and excessive curvature of the nail plate. It is often described as a ‘ram’s horn nail’ or ‘oyster-like.’ While the great toenail is most commonly affected, fingernails may occasionally be involved. Onychogryphosis may be congenital - inherited in an autosomal-dominant pattern, involving all twenty nails or acquired, typically associated with chronic neglect, homelessness, or cognitive decline. Differential diagnosis of congenital onychogryphosis include congenital malalignment and congenital pachyonychia. Management options vary depending on severity, patient factors and include nail avulsion with or without matricectomy, V-Y advancement flap or the Syme technique.[1]
Authors contributions
All the authors have contributed equally in diagnosis and management of the case and preparation of manuscript.
Ethical approval
Institutional Review Board approval is not required.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest
Dr. Shikha Bansal is on the editorial board of the Journal.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil.
References
- Onychogryphosis: Case report and review of the literature. Skin Appendage Disord. 2018;4:326-30.
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