Onychomadesis caused by efinaconazole

Onychomadesis secondary to allergic contact dermatitis to tioconazole contained in a nail lacquer: Description of three cases

“…The pathogenic mechanism is still unclear . The only report of onychomadesis associated with ACD was published in 2017 by Yamaguchi et al In that case, ACD was caused by a 10% topical solution of efinaconazole, a triazole antifungal used to treat tinea unguium . Allergy to tioconazole was repeatedly reported in the literature in the years between 1989 and 1996, but showed a decreasing trend thereafter.…”

“…Two women aged 24 and 31 years, respectively, and a 25-year-old man presented to our department with perionyxis, itchy vesicles, and a purulent exudate from their big toes. The left big toe was affected in the older woman ( Figure 1A) and the right big toe in the man ( Figure 1B), while both big toes were affected in the younger woman ( Figure 1C 1,4 The only report of onychomadesis associated with ACD was published in 2017 by Yamaguchi et al 2 In that case, ACD was caused by a 10% topical solution of efinaconazole, a triazole antifungal used to treat tinea unguium. 2 Allergy to tioconazole was repeatedly reported in the literature in the years between 1989 and 1996, but showed a decreasing trend thereafter.…”

“…1 To the best of our knowledge, only 1 case of an association between onychomadesis and allergic contact dermatitis (ACD) has been reported in the literature. 2 We describe 3 cases of onychomadesis associated with ACD, caused by tioconazole contained in a nail lacquer.…”