Onychial disorders in the older patient

Toenail disorders are a common source of discomfort in the older patient. Changes also contribute to potential and significant morbidity when complicated by systemic diseases. Onychodystrophies, infections, the residual of trauma, changes in relation to age, and manifestations of systemic diseases are identified and explored in this article. Key to proper management is the recognition that diseases and disorders of the toenails are not "routine" and that in the older patients they can limit mobility and significantly increase health care costs when complications ensue.