Onychauxis is a condition also known as nail hypertrophy. It is characterized by the abnormal thickening of the nail plate on the feet or hands.

Acquired thickening of the nail plate typically involves toenails, while congenital thickening of the nail plate is an extremely rare autosomal dominant skin disorder due to mutations in one of the five keratin genes, including K6a, K6b, K6c, K16, or K17, resulting in diffuse thickening of the nails – including all nails.

Some of the causes of this condition include repeated nail damage or insufficient blood supply to the hands and feet. As the nails grow and thicken, it becomes harder to maintain them, and fungal infection can develop. Diagnosis involves assessing the patient’s condition, and in the meantime, treatment includes the use of customized footwear and the removal of severely affected nails to address the fungal infection. Other causes of onychogryphosis include trauma, such as blunt injuries that can damage the matrix, as well as peripheral vascular diseases, psoriasis, syphilis, and fungal infection.

Onychogryphosis describes a nail that resembles a claw, and some authors mention that it resembles the horns of a ram. The matrix produces a nail plate that thickens rather than lengthens, with one side growing faster than the other: the nail plate is thicker, yellowish-brown in color, and distorted, resembling a stone’s shell.

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