Onycholysis

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Onycholysis
Onycholysis left hand 34yo male ring and little fingers non-fungal.jpg
Left hand onycholysis: ring and little fingers affected
Pronunciation
Specialty Dermatology   OOjs UI icon edit-ltr-progressive.svg

Onycholysis is a common medical condition characterized by the painless detachment of the nail from the nail bed, usually starting at the tip and/or sides. [1] On the hands, it occurs particularly on the ring finger but can occur on any of the fingernails. It may also happen to toenails.

Contents

Onycholysis can occur in many conditions, including psoriasis. [2] In thyrotoxicosis, it is thought to be due to sympathetic overactivity. [3] It may also be seen in infections or trauma. [4]

Causes

Treatment

Most instances of onycholysis without a clear cause will heal spontaneously within a few weeks. The most commonly recommended treatment is to keep the nail dry as much as possible and allow the nail to slowly reattach. Trimming away as much loose nail as can be done comfortably will prevent the nail from being pried upwards. Cleaning under the nail is not recommended as this only serves to separate the nail further. Bandages are also to be avoided. [11] When kept dry and away from further trauma, the nail will reattach from the base upward (i.e., from proximal to distal). The aim of treatment is also to eliminate onychomycosis that is a major cause of onycholysis. Antifungals like terbinafin and itraconazole in the form of oral pills should be given for 6 to 8 weeks. [11]

If the underlying cause of the condition is not found and the nail continues to detach despite conservative treatment, the nail bed may begin to form a granular layer of abnormal cells on its surface. After six months of detachment, this layer is likely to prevent the adhesion of any new nail tissue, possibly leading to permanent deformity. [12]

Etymology

The word onycholysis comes from onycho-, from Ancient Greek ὄνυξ ónuks 'nail', and Ancient Greek λύσις lúsis 'lysis/disintegration'. [13]

See also

Related Research Articles

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<span class="mw-page-title-main">Nail disease</span> Medical condition

A nail disease or onychosis is a disease or deformity of the nail. Although the nail is a structure produced by the skin and is a skin appendage, nail diseases have a distinct classification as they have their own signs and symptoms which may relate to other medical conditions. Some nail conditions that show signs of infection or inflammation may require medical assistance.

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<span class="mw-page-title-main">Lichen planus</span> Human chronic inflammatory disease

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<span class="mw-page-title-main">Leukonychia</span> Crescent moon shape on fingernails

Leukonychia is a medical term for white discoloration appearing on nails. It is derived from the Greek words leuko 'white' and onyx 'nail'. The most common cause is injury to the base of the nail where the nail is formed.

<span class="mw-page-title-main">Paronychia</span> Medical condition

Paronychia is an inflammation of the skin around the nail, which can occur suddenly, when it is usually due to the bacterium Staphylococcus aureus, or gradually when it is commonly caused by the fungus Candida albicans. The term is from Greek: παρωνυχία from para 'around', onyx 'nail', and the abstract noun suffix -ia.

<span class="mw-page-title-main">Onychomycosis</span> Medical condition

Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Toenails or fingernails may be affected, but it is more common for toenails. Complications may include cellulitis of the lower leg. A number of different types of fungus can cause onychomycosis, including dermatophytes and Fusarium. Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function. The diagnosis is generally suspected based on the appearance and confirmed by laboratory testing.

Hailey–Hailey disease, or familial benign chronic pemphigus or familial benign pemphigus, was originally described by the Hailey brothers in 1939. It is a genetic disorder that causes blisters to form on the skin.

<span class="mw-page-title-main">Splinter hemorrhage</span> Medical condition

Splinter hemorrhages are tiny blood clots that tend to run vertically under the nails. Splinter hemorrhages are not specific to any particular condition, and can be associated with subacute infective endocarditis, scleroderma, trichinosis, systemic lupus erythematosus (SLE), rheumatoid arthritis, psoriatic nails, antiphospholipid syndrome, haematological malignancy, and trauma. At first they are usually plum-colored, but then darken to brown or black in a couple of days. In certain conditions, clots can migrate from the affected heart valve and find their way into various parts of the body. If this happens in the finger, it can cause damage to the capillaries resulting in a splinter hemorrhage.

Madarosis is a condition that results in the loss of eyelashes, and sometimes eyebrows. The term "madarosis" is derived from the ancient Greek "madaros", meaning "bald". It originally was a disease of only losing eyelashes but it currently is the loss of both eyelashes and eyebrows. Eyebrows and eyelashes are both important in the prevention of bacteria and other foreign objects from entering the eye. A majority of patients with madarosis have leprosy, and it was reported that 76% of patients with varying types of leprosy had madarosis.

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Green nail syndrome is an infection that can develop in individuals whose hands are frequently submerged in water resulting in green discolouration of the nails. It may also occur as transverse green stripes that are ascribed to intermittent episodes of infection. It is usually caused by the bacteria Pseudomonas aeruginosa and is linked to hands being constantly moist or exposed to chemicals, or in individuals who have damaged or traumatised nails. There are several activities and nail injuries or conditions that are linked to higher risk of contracting the condition.

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Onychoschizia, also known as nail splitting and brittle nails, is a splitting of the free-edged tip of the nail. There is also often a longitudinal split in addition to the separation of keratin layers.

Onychorrhexis, is a brittleness with breakage of finger or toenails that may result from hypothyroidism, anemia, anorexia nervosa or bulimia, or after oral retinoid therapy. It can also be seen in melanoma that involves the nail and onychomycosis.

<span class="mw-page-title-main">Psoriatic onychodystrophy</span> Medical condition

Psoriatic onychodystrophy or psoriatic nails is a nail disease. It is common in those with psoriasis, with reported incidences varying from 10% to 78%. Elderly patients and those with psoriatic arthritis are more likely to have psoriatic nails.

<span class="mw-page-title-main">Guttate psoriasis</span> Medical condition

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References

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  8. Hazin, Ribhi; Tamimi, Tarek I. Abu-Rajab; Abuzetun, Jamil Y.; Zein, Nizar N. (October 2009). "Recognizing and treating cutaneous signs of liver disease". Cleveland Clinic Journal of Medicine. 76 (10): 599–606. doi: 10.3949/ccjm.76A.08113 . ISSN   0891-1150. PMID   19797460.
  9. Shah, Selina (April 2010). "Pointe shoes complicate biomechanics of ballet". Lower Extremity Review Magazine.
  10. Niema, Aqil; Aicha, Nassiri; Salim, Gallouj; Fatima Zahra, Mernissi (2019-06-30). "Nail Disorders in Patients with Chronic Renal Failure". Journal of Dermatology Research and Therapy. ClinMed International Library. 5 (1). ISSN   2469-5750.
  11. 1 2 "Onycholysis". American Osteopathic College of Dermatology. Retrieved 29 December 2016.
  12. Richard K. Scherr (1 December 1997). "The Nail Doctor: Onycholysis, or Nail Separation, Has Different Varieties". Nails Magazine.
  13. Services, ProZ com Translation. "lusis | Greek (Ancient) to English | Poetry & Literature". ProZ.com | Freelance translators and interpreters. Retrieved 2022-10-08.