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?
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