Onychomadesis

Onychomadesis

Nails are made up of a variety of structures like nail plate, nail bed, and matrix. It functions in protecting the distal phalanx, the soft tissues surrounding it along with the fingertip. Onychomadesis is a nail disorder characterized by separation of nail plate from nail bed from the proximal end. Shedding of nail occurs; simultaneously, new nail also grows.

Causes and risk factors

The exact cause of onychomadesis remains unknown (idiopathic). Studies have shown that it can be associated with certain underlying diseases, either systemic or skin disorders. Infections like candida and contact dermatitis are some of the common causes. Irritation of nail fold blisters or hemorrhages under nail bed also contribute to the same. Improper blood supply, diabetes mellitus; hand, foot, and mouth diseases are a few other causes that can result in separation of nail plate. Onychomadesis is commonly seen as a side effect of radiation, chemotherapy, and certain other medications. Use of contaminated equipment at a saloon or spa is one of the main contributing factors to trigger infection or nail disorders. Although still not clear, emotional stress is another contributing factor.

 

Clinical presentation:

The symptoms are more prominently seen in dark complexioned people. Some patients may remain asymptomatic while a few others can present with complaints of white strips on the nails. One or all the nails can be affected. Longitudinal lines are seen or an entire nail can be affected. With the thickening of the nails, dull appearance of nails and arrested nail growth can be seen. The nails become brittle and they break off easily. Apart from these complaints, the white and dull appearance of the nails can be a matter of worry from a cosmetic point of view.

 

Investigations

The diagnosis is done on the basis of the symptoms narrated by the patient and physical examination carried out by the dermatologist. Dermoscopic examination along with nail biopsy is the diagnostic investigation available.

 

Treatment

As in most of the cases, onychomadesis is caused due to certain underlying diseases, and treating the underlying cause is the main line of treatment. If a certain medication has induced this condition, it needs to be stopped immediately. Proper care of nails is of foremost importance. In spite of treatment, if the infection tends to reoccur in some cases, mechanical removal of the nails can be done.

 

Other modes of treatment:

Certain other modes of treatment can also be helpful in coping up with the disease. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.

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