Onychogryphosis is a disorder of nail plate growth that is clinically characterized by an opaque, yellow-brown thickening of the nail plate with associated gross hyperkeratosis, elongation, and increased curvature. It is most common in older adults and patients with poor personal care. It is a relatively common and important condition because patients may suffer from pain, secondary complications, and cosmetic concerns. We present the case of a 67-year-old man with a 30-year history of severe thickening, abnormal growth, and yellow discoloration of his left great toenail, clinically consistent with onychogryphosis. This review highlights the etiology, diagnosis, and treatment options for onychogryphosis.
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