Onycholysis is the painless separation of the nail plate from the nail bed, starting at the tip and progressing backward. It often leads to a white or yellowish discoloration under the nail.
🔍 Features of Onycholysis
- Nail lifts off from the nail bed
- Creates a space between nail and skin that may accumulate debris
- Usually painless but can cause discomfort if infection develops
- Affects fingernails or toenails
⚠️ Causes
| Category | Examples |
|---|---|
| Trauma | Frequent nail tapping, manicures, tight shoes |
| Infections | Fungal infections (onychomycosis), bacterial infections |
| Dermatologic conditions | Psoriasis, eczema, lichen planus |
| Systemic diseases | Thyroid disorders (hyperthyroidism), diabetes |
| Medications | Tetracycline, chemotherapy agents |
| Chemical exposure | Excessive exposure to detergents, irritants |
🔍 Signs and Symptoms
- White or yellow discoloration under the nail
- Nail may appear thickened or brittle
- Nail plate gradually separates, starting at the tip
- Possible mild irritation but often painless
🛠️ Diagnosis
- Clinical examination
- Nail clippings or scrapings for fungal culture or microscopy
- Blood tests if systemic disease suspected
💊 Treatment
- Identify and treat underlying cause (e.g., antifungals for fungal infection)
- Avoid trauma and chemical irritants
- Keep nails trimmed and dry
- Use protective gloves when handling chemicals
- In some cases, topical corticosteroids if associated with psoriasis