Anonymity (overview) Q84.30

Complete or partial, acquired or congenital "naillessness" on fingers and/or toes

Acquired Anonychia:

• Traumatically induced
• unguinea unguium
• lichen planus
• Chronic eczema diseases
• psoriasis vulgaris
• Acrodermatitis continua suppurativa
• Syphilis
• Erythroderma of different genesis
• Medically acquired with prenatal phenytoin intake.

Congenital Anonychia: A number of different syndromes have been described:

• Anonychia congenita: In autosomal recessive congenital anonychia (OMIM 206800) the leading symptom is the already congenitally appearing anoynchia (no hypoplasia of the bony end phalanges). Mutations in the RSPO4 gene, which codes for R-spondin 4, a component of the Wnt signalling pathway, have been demonstrated.
• In the mamma-fingernail syndrome the nails are missing in hypoplasia or complete absence of the end phalanges.
• In Cooks syndrome, nail dystrophy progresses to ring and little finger anonymity and thumb digitalization.
• In the Anonychia Electrodactylya syndrome, the finger anomalies are asymmetrical, including the absence of 1 or more fingers.
• 20-nail dystrophy
• Nail-patella syndrome (Anonychia, hyponychia, onychoschisis, triangular lunula. Affected are mainly thumb and index finger nails; toenails are almost always normal).
• Isolated onycholysis of ononychia (nail disorder, nonsyndromic congenital 9: this is an autosomal recessive inherited nail dystrophy. The nails appear normal at birth; in the first decade of life onycholysis of the toenails leading to anonychia)

In the case of acquired anonymity: treatment of the underlying disease, see there.

1. Afsar FS et al (2014) Total congenital anonychia. Pediatric dermatol 31:743-744
2. Babu S et al (2012) Anonychia due to prenatal phenytoin exposure. J Assoc Physicians India 60:64
3. Balta I et al (2013) A case report on autosomal recessive total congenital anonychia. Pediatric Dermatol 30: e268-269
4. de Lau WB et al (2012) The R-spondin protein family. Genomes Biol.13:242
5. Lam C et al (2013) Images in clinical medicine. Epidermolysis bullosa acquisita. N Engl J Med 368:e17
6. Khan TN et al (2012) Novel missense mutation in the RSPO4 gene in congenital hyponychia and evidence for a polymorphic initiation codon (p.M1I). BMC Med gene 13:120