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Ram’s horn nails

Nicola Mumoli
Med J Aust 2011; 195 (4): 202.

A 60-year-old woman with a history of severe depression presented with erysipelas of the lower limbs. Her feet were malodorous, with thickened skin, a leathery texture, hyperkeratosis and fissuring. Severe onychogryphosis was also observed (Box). She lived in a country house with her son, who was developmentally delayed, in conditions of poor hygiene, and refused any outside assistance.

Nicola Mumoli, Cardiologist
Department of Internal Medicine, Ospedale Civile Livorno, Livorno, Italy.

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