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Onycholysis is the gradual separation of a fingernl or toenl from its pink nl bedan often pnless occurrence that may require attention for appropriate care. Commonly triggered by minor trauma such as dly tapping on surfaces like keyboards or counters and improper manicure techniques, this condition can also result from excessive moisture in the environment where nls are regularly exposed.
Beyond traumatic causes, various medical conditions can contribute to onycholysis through alterations of nl shape or contour distortion affecting how it adheres to its bed. Fungal infections cause thickening under the nl plate leading to the edge lifting away, while skin disorders such as allergic reactions and psoriasis frequently present with similar symptoms. Medications from certn groups like psoralens, tetracyclines, fluoroquinolones may cause onycholysis when exposed to sunlight after use, and hyperthyroidism or iron deficiency can be associated with this nl disorder.
Symptoms of Onycholysis:
Onycholysis is characterized by a distorted edge between the pink portion of the nl and its white outer border. The affected nls might become opaque, white, yellowish, or greenish in color. Thickened skin beneath the nl's edge can accumulate, alongside an irregular nl plate that appears pitted, bent, or thickened.
Diagnosis:
Physicians can confirm onycholysis by inspecting affected nls and taking note of characteristics like nl shape and discoloration, indentations on its surface, and skin condition around it. When unsure of the cause, doctors may examine for signs of rashes or thyroid issues.
In cases suspecting fungal infection, a doctor may scrape tissue beneath the nl plate. Laboratory testing can detect fungus present in the sample collected for analysis.
Expected Duration:
Nls grow slowly and take time to repr themselves; thus, the part that separates from its skin surface doesn't reattach. It takes four to six months for fingernls to fully regrow while toenls require twice as much time. Some nl problems may be difficult to cure permanently affecting their appearance.
Prevention:
To minimize chances of onycholysis:
Keep nls trimmed at a comfortable length to reduce trauma from everyday use.
Use rubber gloves to prevent repetitive immersion in water which can make nls brittle and prone to splitting or breaking.
Avoid harsh chemicals like nl polish remover that may weaken nl structure.
Minimize exposure to wet environments where nls are more susceptible to fungus growth.
Treatment:
Nl care professionals might advise trimming the affected nls close to the separation point during routine visits.
Treatment for medical conditions related to onycholysis includes managing hyperthyroidism and iron deficiency to allow normal nl regrowth. Topical or oral medications may help with psoriasis management, while antifungal treatments are avlable for fungal infections when necessary. However, these treatments have potential side effects, can be costly and not always covered by insurance.
Consultation:
Onycholysis is typically not an urgent concern and often addressed during routine check-ups at the doctor's office.
Prognosis:
Though nl changes usually aren't permanent, they may take several months to disappear even after effective treatment.
About the Reviewer:
Howard E. LeWine, MD, is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor-in-chief of Harvard Men's Health Watch.
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:
This content is inted for informational purposes only and should never replace professional medical advice from a doctor or qualified healthcare practitioner.
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