What happened to the nails on this 69-year-old's toes?

A 69-year-old man is disturbed by the condition of the nails on both great toes.

What does this look like to you?

A. Onychomadesis.

B. Onycholysis.

C. Onychogryphosis.

D. Trachyonychia.

E. Onychoschizia.

(Answer on next page.)
 

Answer: Onychogryphosis

This condition is onychogryphosis, C, hypertrophy of the nails that leads to curved growth and a claw-like configuration. Onychogryphosis usually affects the nail of the great toe; it can be caused by trauma, hallux valgus, chronic venous insufficiency, and epidermal dysplasias. Filing the nail and applications of urea paste may ease the condition; nail removal or matrixectomy may be necessary in resistant cases.

Onychomadesis is nail shedding; onycholysis is separation of the nail plate from the nail bed. Rough, brittle nails characterize trachyonychia; lamellar splitting of the distal nail plate is onychoschizia.