Dermoscopy-aided diagnosis of uncommon onychauxis in a 21-year-old: A case report and review of the literature.

Onychauxis, described as localized hypertrophy of the nail plate manifests as a thick, hyperkeratotic, and discolored nail. It is most commonly reported among the elderly and sometimes misdiagnosed as onychomycosis. In this case report, we present a rare occurrence of onychauxis in a 21‑year‑old male, complicated by onychocryptosis of both the medial and lateral nail folds of the left great toe and exacerbated by concurrent onychomycosis. Diagnosis was supported by dermoscopy, an increasingly utilized tool in evaluating fungal nail infections. Surgical nail avulsion followed by oral antifungal therapy resulted in improvement. This report underscores the importance of considering fungal etiologies in younger patients with severe nail dystrophy and highlights the role of dermoscopy in outpatient diagnostic workflow.