Combination urea and salicyclic acid ointment nail avulsion in nondystrophic nails: a follow-up observation

Following the initial report by Farber and South on nonsurgical nail avulsion with urea ointment and their emphasis that the therapy was not helpful in treating nondystrophic nails, we utilized a similar therapy to treat a sixty-seven year old patient who had severe arteriosclerotic cardiovascular disease and relatively nondystrophic but symptomatic large toenail disease. Because their formulation was ineffective on nondystrophic nails, a formulation with an additive, 20 percent urea and 10 percent salicylic acid preparation was used. After a period of two weeks of occlusive paplication, painless nonsurgical avulsion was achieved. Moderate maceration of surrounding skin was temporary and relatively asymptomatic.