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Our Dermatol Online. 2011; 2(4): 227-228
Date of submission: 05.02.2011 / acceptance: 12.04.2011
Conflicts of interest: None



Patricia Chang

Dermatologist Hospital General de Enfermedades IGSS y Hospital Ángeles Guatemala

Corresponding author: Dr. Patricia Chang    e-mail: pchang2622@gmail.com

Onychogryphosis a disorder that is characterized by the hypertrophy and excessive curving of the nails [1], also known as "Ram's horn nails [2] is a hypertrophy that may produce nails resembling claws or a ram's horn, possibly caused by trauma or peripheral vascular disorders, but most often secondary to neglect and failure to cut the nails for extended periods of time and is most common ly seen in the elderly [3]. It can affect the fingernails and toenails [1] are seen in later life especially in the big toe-nail is severely disorted, thickened and interferes with the wearing shoes. May be caused by poor blood circulation to the feet, diabetes, nutritional deficiencies and tight-fitting shoes, foot anomalies such as hallux valgus, old age, uricaemia, ichthyosis, psoriasis, onychomycosis, local injury to the nail apparatus, repeated minor trauma caused by footwear, pathology in the peripheral nervous system, syphilis, phemphigus and variola [1,4]. Etymology: Gk, onyx + gryphein, to curve, osis, condition [5] Onychogryphosis may rarely occur as a development abnormality but is usually acquired, its irregular surface is marked by transverse striations, sometimes this nail is oyster like. Appears in cases of self-neglect and is often seen in tramps and senile dementia. Idiopathic forms are acquired and hereditary [4]. Conservative treatment is especially useful in feet at high risk patients with vascular disease and diabetes and trimming the thickened nail by means of an electric drull and burrs and the removal of subungual keratoses, chemical nail destruction using 40% or 50%, avulsion of the nail plate with surgical destruction of the matrix with phenol or the CO2 laser, if the blood supply is good.
Figure 1. Onychogryphosis as Ram's horn nails
Figure 2. Nails thickened in onychogryphosis
Figure 3. Nails thickened in onychogryphosis
Figure 4. Onychogryphosis in a female patient 80 years old
Figure 5. Close up of the nail disease
Figure 6. Onychogryphosis of the toenails in male patient 89 years old
Figure 7. Onychogryphosis of the toenails lateral view
Figure 8. Transverse striations in onychogryphosis
1.http://www.wrongdiagnosis.com/o/onychogryphosis/basic s.htm visited 02-4-2011.
2. Rapini, Ronald P, Bolognia, Jean L, Jorizzo, Joseph L: Dermatology. 2. St. Louis: Mosby 2007.
3. Berger JW, Elston T: Dirk. Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders 2005.
4. Baran R, Dawber RPR: Diseases of the Nails and their Management. Blackwell Scientific Publications. 46-47, 393- 394. London1994. 5.http://medicaldictionary.thefreedictionary.com/onychogry phosis



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