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Other namesOnychogryposis or Ram's horn nails[1]
SpecialtyDermatology Edit this on Wikidata

Onychogryphosis is a hypertrophy that may produce nails resembling claws or a ram's horn.


Onychogryphosis demonstrating the characteristic ram's horn appearance
Ram's horn toenails on a bedridden patient

Onychogryphosis may be caused by trauma or peripheral vascular disease, but most often secondary to self-neglect and failure to cut the nails for extended periods of time.[2]:783–4[3] This condition is most commonly seen in the elderly.



Some recommend avulsion of the nail plate with surgical destruction of the nail matrix with phenol or the carbon dioxide laser, if the blood supply is adequate.[2]:783–4[4]:659


Severe congenital onychogryphosis affecting all twenty nailbeds has been recorded in two families who exhibit the dominant allele for a certain gene.[5][6] Congenital onychogryphosis of the fifth toe (the baby, little, pinky or small toe) is fairly common, but asymptomatic and seldom brought to the attention of medical professionals. Rather, it is brought to the attention of manicurists who routinely file the clawed toenail flat.

See also[edit]


  1. ^ Tosti, A; Piraccini, BM (2008). "Chapter 70 – Nail Disorders". In Bolognia, JL; Jorizzo, JL; Rapini, RP (eds.). Dermatology. 1 (2nd ed.). St. Louis: Mosby Elsevier. ISBN 978-1-4160-2999-1.
  2. ^ a b James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  3. ^ Ram’s horn nails, Dr Nicola Mumoli (cardiologist) - Department of Internal Medicine, Ospedale Civile Livorno, Livorno, Italy, reported in Medical Journal of Australia, MJA 2011; 195 (4): 202, 15 August 2011, accessed 1 September 2011
  4. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  5. ^ Sequeira JH (1923). "Case of Congenital Onychogryphosis". Proc. R. Soc. Med. 16 (Dermatol Sect): 92. PMC 2103814. PMID 19982897.
  6. ^ Porteus HB (1954). "A case of onychogryphosis". Br Med J. 2 (4892): 851–2. doi:10.1136/bmj.2.4892.851. PMC 2079501. PMID 13199328.

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