In onychogryphosis there is a rams horn-shaped deformity of the nail. The nail is usually markedly thickened and excessively long. It can occur on fingernails, but is much more common on toenails. This condition usually occurs on the thumb or fingers because of trauma, infection, a congenital defect, or surgery.

Orville J. Stone, M.d. is a dermatologist practicing in Southern California. He has taught at medical schools for 30 years and has published 150 scientific papers. His first paper on nail disorders appeared in 1962.

Orville J. Stone, M.d. is a dermatologist practicing in Southern California. He has taught at medical schools for 30 years and has published 150 scientific papers. His first paper on nail disorders appeared in 1962. 

Toenail deformities most commonly occur in persons who have been disabled or who have had chronic swelling of the feet.

I took photographs of the toes of a woman who had onychogryphosis. She had severe swelling of her feet and I arranged for her to receive regular nursing care. Much to my surprise, I was able to document and publish the normal growth of the nail once swelling was reduced. Until that time, dermatologists thought of this as a permanent deformity.

Understanding onychogryphosis illustrates a number of principles that are valuable for total understanding of the nail. Some patients with onychogryphosis can be greatly aided by a nail technician. At times I have seen fairly dramatic cosmetic improvement by proper handling of the basic defect and the application of nail techniques.

Most of the fingernail changes occur as a direct result of severe trauma to the nail. A number of distinct changes can occur. One side of the nail grows faster than the other. The speeding up of one side or slowing down of the other side would give the same result. If you think of the nail as a sheet of plastic being extruded from a mold, the changes will make sense. Additionally, the damaged nail is moving outward slower than its normal rate, and the nail cells pile up thicker. As a consequence of thickness, the nails are often left untrimmed. Leaving this condition untreated adds trauma to the nail and further increases the damage.

I trim the nails with a clipper or a rotary drill. I suggest a rotary file on the fingernail to thin down the deformity, then following that with a cosmetic procedure to make the nail appear like the others.

When trimming these thickened and deformed nails, watch out for the presence of soft, normal tissue, which can sometimes extend to the center. A tube of tissue extending out through the center of the lesions would not be unusual, but clipping this can cause the client pain and bleeding.

When I see a deformed nail, I ask the patient if she wants it trimmed. I do not charge extra and it just takes a few seconds. I note the need for nail care on the chart and do it as often as necessary. The patient is extremely grateful. You can always find someone to drink coffee or beer with you, but no one wants to trim your nails.

 

BACKSCRATCHERS IS GOING PLACES

This shows how onychogryphosis is resolved after clearing chronic swelling of the patient's foot.

This shows how onychogryphosis is resolved after clearing chronic swelling of the patient's foot.

Backscratchers is getting around. After signing West Coast Beauty Supply as a new distributor, the company participated in the 45th West Coast Beauty Supply tradeshow in San Francisco with its award-winning booth, product demonstrations, and in-depth classes. Owners Jack and Michael Megna worked the floor along with six other staff members.

The Backscratchers Glass Glaze fiberglass nail wrap system took third place in the overall nail competition at the Dusseldorf Beauty 1992 Show in Dusseldorf, Germany. Third-place winner Margareta Sundstrom of Stockholm, Sweden, missed taking first place by only two points.

The Holiday Inn in Taunton, Mass. More than 700 nail technicians attended to participate in educational seminars, view new products, and win door prizes, including a pair of $700 diamond earrings donated by Kay Jewelers. An appearance by local TV personality George Allen added to the festivities. The show was rated a big success and plans are already in the works for another show scheduled for November 22, 1992, at the same location. For more information, write to Nail Essentials Nail Supply, 544 Milford Rd., Swansea, MA 02777, or call (800) 448-1530 outside MA, or (508) 676-3453.

 

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