Author: Vanessa Ngan, Staff Writer, 2003.
Onycholysis is a common nail disorder. It is the loosening or separation of a fingernail or toenail from its nail bed. It usually starts at the tip of the nail and progresses back.
Many things may cause onycholysis. Some of the most common causes are:
Other causes of onycholysis are shown in the following table.
|Skin disease||Psoriasis, dermatitis and less often, pemphigus vulgaris, porphyria cutanea tarda and others|
|Internal disease (uncommon)||Amyloid and multiple myeloma, anaemia (iron deficiency), diabetes mellitus, erythropoietic porphyria, hyperhidrosis, hyperthyroidism, hypothyroidism, impaired peripheral circulation, leprosy, pellagra, psoriatic arthritis, Reiter syndrome, sarcoidosis, scleroderma, yellow nail syndrome due to chronic lung or sinus disease|
|Other||Congenital onycholysis, hereditary partial onycholysis, idiopathic acquired onycholysis, hereditary distal onycholysis, foreign body implantation, contact allergy to nail glue (acrylate)|
People of all ages, sex and race can get onycholysis, although it is more frequently seen in female adults.
Because so many things can cause onycholysis, your doctor may examine you to check for other skin conditions or medical problems such as thyroid disease. If a fungal infection is suspected, your doctor may clip the nail and scrape a sample of tissue from beneath the nail plate for laboratory testing.
Treatment of onycholysis depends on the cause of the problem. Eliminating or correcting the predisposing cause is the best treatment. For example, treatment of hyperthyroidism will allow the nails to regrow normally and nail infections can be treated with antimicrobials.
The portion of nail that has separated will not reattach to the nail bed and you will have to wait until the nail is fully regrown for the condition to be completely gone. Fingernails take 4-6 months to fully regrow whilst toenails may take twice as long.
To prevent deterioration or recurrence of onycholysis after it has cleared up:
Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.
See the DermNet NZ bookstore
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