Ram’s horn nails
Author: Nicola Mumoli
Published online: 15 August 2011
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.
Onychogryphosis (also known as “ram’s horn nails”) may be associated with several factors, including peripheral vascular disorders, infection, injury, diabetes, or the inadequate intake of nutrients, but most often, as in this case, it occurs as a result of long-term neglect.
