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I had a patient today who is an 8 year old boy, presented with onychogryphosis, onychauxis, general onychodystrophy etc (in almost all the toes, but worse in hallux b/f), things that we all see on a daily basis in the elderly patient. This was most unusual in that it was in an 8 year old boy and that the mother said that he has had it since being a baby. (Pregnancy and birth all normal and unremarkable). Its one thing to see these things in the elderly patient after a lifetime of bad footwear, trauma, sports, neglect, etc, but you don't often see this in a young child who has had it since being a baby. Anyone else seen this kind of thing before? Any ideas on the etiology? Any ideas on treatment other than the general treatment we normally give to the elderly?
you dont think thats a bit radical ?i guess the question then is if its better not to have any nails or have to come back for regular treatment.
Patient's choice of course although I too would advise nail surgery on all nails over a period of time. This would save the patient years of attending regular podiatry appointments though his life. Both cost & time effective.
Suffering a fondness for odd things.
“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”
came on this thread while looking up for a concerned parent. female child 2yo, no medical history, gryphotic 3,4,5. normal 1,2 and normal finger nails. no family history and no fungus present by visual and c&m. parents concerned about appearance when older, ablation and phenol seem a tad extreme for a 2yo, does anyone else have a strategy?
I've been treating a little girl and little boy with same condition for a few years - no infection according to lab evaluation, simply gryphosis of 3rd, 4th & 5th on both feet (iu pressure or lack of amniotic fluid perhaps ... guessing?).
The little girl presented to my clinic at 8 months old and the boy at aged 5. The parents were too worried about cutting the nails themselves. It took several treatments to gain the trust of the children but they are now happy to let me drill them down and cut them - they only need to come about 3-4 times a year and they now enjoy their visits.
I would consider that if the nails are not painful, leave them alone and treat conservatively until old enough to make their own decisions about whether they want to have nail surgery or not.
What procedure would you use for removal of nails? What follow-up care would be needed? Length of recovery time? I've noticed artificial toenails are available; would this be a good option for paitients, especially females, who like to wear open toed shoes. Thanx in advance.