Brachyonychia Q84.6

Ronchese 1973

Hereditary, shortened, plump distal phalanx with shortened and widened nail plate and slight curvature of the distal nail edge. This results in a "tennis racket-like" appearance. In the majority of cases only one or both thumbs are affected. Racket nails of fingers 1-4 are rare. Coincidence with systemic scleroderma is described.

Autosomal dominant inherited with varying expressiveness. Brachyonychia is also observed in onychophagia (nail biting). Ovenable, repeated severe cold traumas may be associated with secondary osteolysis and brachyonychia in appropriately predisposed individuals (tendency to Raynaud's symptoms or frostbite).

Brachyonychia is the most common profile change of the nails. Women are 3 times more frequently affected than men.

Reports of racket nails in hyperparathyroidism have been published.

1. Bakhach J et al (2003) The eponychial flap: A new technique to restore the length of a short nail. J Hand Surg 28 (Suppl 1): 76
2. El-Komy MH, Baran R (2014) Acroosteolysis presenting with brachyonychia following exposure to cold. J Eur Acad Dermatol Venereol doi: 10.1111/jdv.12826
3. Rasi A et al (2006) Circumscribed juvenile-onset pityriasis rubra pilaris with hypoparathyroidism and brachyonychia. Cutis 77:218-222
4. Wollina U (1990) Racket nails of all fingers and progressive systemic scleroderma. Act Dermatol 16: 175-176
5. Zaun H et al (1987) Brachyonychia of different types in mother and daughter. Dermatologist 38: 104-106