Congenital Onychodystrophy of the Index Fingers Differential Diagnoses
- Author: Gregory J Raugi, MD, PhD; Chief Editor: William D James, MD more...
Clouston syndrome (hidrotic ectodermal dysplasia): Patients with this syndrome are born with nails, but then lose them. These patients also have patchy alopecia and palmoplantar keratoderma and lack the radiographic abnormalities of the distal phalanges as found in patients with congenital onychodystrophy of the index fingers (COIF).
Congenital anonychia: Unlike patients with congenital onychodystrophy of the index finger, patients with congenital anonychia lack skeletal abnormalities of the distal phalanges.
Fetal antiepileptic drugs (AED) syndrome: Patients with this syndrome have major malformations, minor anomalies, microcephaly, cognitive impairment, cleft lip and/or cleft palate, heart defects, growth retardation, midface hypoplasia, hypoplasia of the fingers. The physical features of infants exposed to various anticonvulsant drugs are not the same.
Nail-patella syndrome: One third of patients with nail-patella syndrome have abnormalities limited to just the thumbnails, one third have abnormalities of the thumbnails and other selected nails, and one third have abnormalities of all fingernails.
Poland syndrome: Distinguishing features of this syndrome are a congenital absence of the pectoralis major muscle on the ipsilateral side of the digits displaying congenital onychodystrophy of the index finger–like findings.
Individuals can have congenital onychodystrophy and no related findings. However, identification of vestigial nails (onychodystrophy) is crucial for the correct diagnosis of DOOR (deafness, onychodystrophy, osteodystrophy, and mental retardation) syndrome.
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