Onychogryphosis is an acquired nail plate change. It often affects the toenail
and is characterized by an opaque, yellow-brownish nail plate that is distorted,
grossly thickened, elongated, and partly curved resembling a ram's horn.
Tuberous sclerosis complex is a multisystem disorder associated with high rates
of mental retardation, autism, cognitive impairment, behavioral problems, or
seizures. Nail disease can also be associated, which is a concern to patients
due to pain and nail distortion. We reported a typical tuberous sclerosis
complex patient with distinctive clinical features of a ram's horn nails, which
presented a great challenge to surgical treatment and nail restoration.
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