Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:
-- The first section of this topic is shown below --
- Onychogryphosis describes claw-like hypertrophy and thickening of the entire nail plate, involving most commonly the great toe, leading to severely distorted, brownish, spiraled nails detached from the nail bed.
- The exaggerated growth of the nail is usually upward/lateral, with superficial transverse striations, and pain can be elicited with applied pressure.
Onychogryphosis occurs in 5% of the world population.
Etiology and Pathophysiology
- The nail bed matrix produces the nail plate at uneven rates.
- It is thought the faster growing side of uneven keratin production at the nail bed determines the direction of the nail deformity (1).
- Several proposed theories for the cause of onychogryphosis:
- Pressure or friction from footwear
- Decreased perfusion secondary to peripheral vascular disorders
- Hallux valgus
- Systemic diseases such as:
- CNS diseases
- Syphilis, pemphigus, and variola
- Hansen disease
- Autosomal dominant condition, where the nails of the hands and the feet are involved, most notably in the 1st year of life
Autosomal dominant in some cases
- Playing high-friction sports, such as football
- Older individuals
- Subungual epidermophytosis
- Diabetes mellitus
- Congenital malalignment of the great toenails (CMGT)
- Avoid injuries to the fingers and toes.
- Avoid compact footwear.
- Avoid nail polish, as this causes trapping of moisture under the nail.
Commonly Associated Conditions