Dolichonychia in women with Marfan syndrome

Dolichonychia refers to nails that are elongated and slender. This nail morphology has been described in single case reports of patients with Ehlers-Danlos syndrome, hypohidrotic ectodermal dysplasia, and Marfan syndrome.

The length and width of fingernails were measured in patients with Marfan syndrome and in individuals without the syndrome. A fingernail index was calculated for each person. A non-parametric sign test was used to compare the mean fingernail index of patients with Marfan syndrome and control subjects.

The fingernail index ranged from 0.92 to 1.52 in patients with Marfan syndrome and from 0.77 to 1.30 in control individuals. The median fingernail index in women with Marfan syndrome (1.455) was significantly greater than the median fingernail index in women control subjects (1.080) (P = 0.035). Dolichonychia, defined as a fingernail index greater than or equal to 1.30, was present in six of eight (75%) of women with Marfan syndrome as compared with only one of 40 (2.5%) of women control subjects.

Dolichonychia is a physical finding present in some patients with Marfan syndrome. The detection of long narrow fingernails in women should suggest the possibility of Marfan syndrome.