Congenital Brachyonychia

Overview

Non-mycotic onychopathies account for ca 50% of deformaties of the nails and their knowledgeis therefore important for the differential diagnosis of onychomycoses. Most difficulties are causedby those cases where a non-mycotic onychopathy combines with a secondary mycotic infection. Theauthors describe a female patient with onychomycosis on the feet confirmed by laboratory tests andchanges on he thumbs, which at first by their clinical appearance also suggested onychomycosis.Only the difference in the response to systemic treatment with itraconazole (4 pulses) when the toenails healed while the nails on the hands remained short and fringed drew attention to the differentetiology. An X-ray of the thumbs revealed shorter last phalangi. The patient admitted that the nailsof the thumbs were shorter and broader since birth, however only in recent years they thickenedand became discolored.

Key words:
onychomycoses - differential diagnosis - brachyonychia