Simple onycholysis: A diagnosis of exclusion

Vélez, Nicole F.; Jellinek, Nathaniel J.

doi:10.1016/j.jaad.2013.09.061

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…5,9 Avoidance of contact irritant also plays a huge role in the regrowth of the affected nail. However, when onycholysis is not associated with any such predisposing factors, then it is diagnosed by exclusion as simple onycholysis 12 which is challenging to treat.…”

Section: Introductionmentioning

confidence: 99%

Individualised Homoeopathy in the Treatment of Onycholysis: An Evidence-Based Clinical Case Report

et al. 2021

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Introduction Onycholysis is a chronic nail disorder characterised by the progressive separation of the nail plate from the underlying nail bed. Apart from causing pain and discomfort, it affects the quality of life of an individual due to its visualised cosmetic appearance. Case Summary A 45-year-old female presented with complete loss of nail plate of the left middle finger for 1 month. At the first visit, homoeopathic medicine Tuberculinum bovinum was prescribed and the patient was followed up periodically for 4 months. A series of photographs captured at the first visit and in subsequent visits objectively document the gradual regrowth of her nail plate. Various aspects of her subjective improvement were documented by three validated outcome measurement scales. The patient herself assessed that, after 4 months of follow-up, she is ‘back to normal’ for her main complaint as well as for the overall well-being, which is documented as a +4 score in ‘Outcome in Relation to Impact on Daily Living’ (ORIDL) scale. The Dermatology Life Quality Index (DLQI) score was reduced from 20 at the first visit to 1 after 4 months of treatment. Modified Naranjo Criteria for Homeopathy (MONARCH) score recorded at the final visit (+8 in ‘-6 to +13’ scale) is suggestive of a high likelihood that the improvement in the patient can be attributed to the homoeopathic treatment provided. Conclusion This clinical case report is presented here to critically document the effect of individualised homoeopathic treatment in onycholysis within a plausible timeframe.

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Section: Introductionmentioning

confidence: 99%

Individualised Homoeopathy in the Treatment of Onycholysis: An Evidence-Based Clinical Case Report

et al. 2021

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“…5,7,9 Onycholysis has been classified as primary (if there is no obvious cause of it) or secondary (if it is caused by any of the above-mentioned causes). 11,12 Onycholysis has been classified in five stages according to the degree of detachment the nail plate, as follows (Figure 1) 13 : (I) Early, initial separation of 1-2 mm of the distal nail plate from the hyponychium. (II) Separation of the distal one-third of the nail plate.…”

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confidence: 99%

Pattern diagnosis of onycholysis

Navarro

2023

JEADV Clinical Practice

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Onycholysis is defined as the detachment of the nail plate from the underlying and/or lateral supporting structures. Trauma, inflammatory conditions, infectious agents, tumours and toxic substances are the most commonly reported causes of onycholysis. We review the main causes of onycholysis in clinical practice and provide a diagnostic approach based on morphologic patterns of the proximal border of onycholysis, as defined by clinical and dermoscopic examination. Four morphologic patterns of onycholysis, namely transversal, lateral, V-shaped and circular are presented with their most common causes and triggers.

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“…The causes include dermatologic, infective, systemic, or drugs [ Table 1 ]. [ 1 ] However, in a substantial number of cases, no underlying cause can be found; hence, it is labelled as primary onycholysis. This distolateral separation with proximal extension, appears white due to entrapment of air and keratinous debris; however, secondary invasion by microorganisms ( Candida spp , Pseudomonas , etc.)…”

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confidence: 99%

“…Primary onycholysis, also known as simple/idiopathic onycholysis (IO) is a diagnosis of exclusion, occurring mostly in females, with onset in adulthood, though any age group can be affected. [ 1 2 ] Histopathology is non-specific and management is poorly defined [ Table 2 ]. [ 3 4 5 ] We report two cases with response to topical triple combination therapy combined with irritant avoidance.…”

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confidence: 99%