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HYPONYCHIUM ABNORMALITIES Congenital Aberrant Hyponychium vs. Acquired Pterygium Inversum Unguis vs. Acquired Reversible Extended Hyponychium: a proposed classification based on origin, pathology and outcome.

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Finger and toenail onycholysis.

N Zaias1, S X Escovar, M N Zaiac

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|December 17, 2014
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Summary
This summary is machine-generated.

Onycholysis, nail separation, has different causes for fingers and toes. Finger onycholysis is often linked to trauma or psoriasis, while toenail issues stem from shoe pressure and foot mechanics.

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Area of Science:

  • Dermatology
  • Nail Diseases

Background:

  • Onycholysis is the separation of the nail plate from the nail bed, presenting as a whitish discoloration.
  • Fingernail onycholysis is frequently observed in women and can be associated with trauma, psoriasis, or drug reactions.
  • Toenail onycholysis typically results from mechanical pressure, often exacerbated by footwear and foot biomechanics.

Purpose of the Study:

  • To differentiate the causes and treatment of fingernail versus toenail onycholysis.
  • To investigate the role of microbial colonization in fingernail onycholysis.
  • To propose effective management strategies for both types of onycholysis.

Main Methods:

  • Clinical observation and diagnosis of onycholysis cases.
  • Review of common etiological factors for fingernail and toenail onycholysis.
  • Analysis of microbial flora in onycholytic nail spaces.
  • Evaluation of treatment outcomes based on proposed etiologies.

Main Results:

  • Fingernail onycholysis commonly arises from trauma, psoriasis, or drug-induced phototoxic dermatitis.
  • Candida albicans and Pseudomonas are frequently isolated from fingernail onycholysis but are often secondary colonizers, not primary causes.
  • Toenail onycholysis is primarily attributed to mechanical stress from footwear interacting with foot biomechanics, such as uneven gait.
  • Drying the affected nail area is an effective treatment for fingernail onycholysis by eliminating moisture-dependent biota.

Conclusions:

  • Fingernail and toenail onycholysis have distinct etiologies requiring different management approaches.
  • Microbial presence in fingernail onycholysis is often incidental, and antifungal treatment does not typically resolve the condition.
  • Mechanical factors and footwear are key in toenail onycholysis, necessitating attention to shoe fit and gait.
  • Simple drying techniques can effectively manage secondary infections in fingernail onycholysis.