Onychomadesis - Nail and Distal Digit
Alerts and Notices
Synopsis
Nail matrix arrest may be due to either local or systemic disease. Known associations with onychomadesis include infections, medications (particularly chemotherapies), radiation, autoimmune diseases (pemphigus vulgaris, alopecia areata, bullous pemphigoid), finger or wrist fracture with cast immobilization, high altitude, deep-sea dives, systemic disease (reflex sympathetic dystrophy, diabetes mellitus, dialysis, Raynaud phenomenon), yellow nail syndrome, keratosis punctata, acute paronychia, and repeated local trauma from footwear. Cases may be idiopathic. A rare familial form with autosomal dominant inheritance has been reported.
When acute, the condition may be associated with swelling of the proximal nail fold due to an elevation of the proximal part of the nail plate. The course is typically self-limited.
Pathophysiologically, retronychia is similar to onychomadesis, but the new nail plate grows vertically into the proximal nail fold.
In children, hand-foot-and-mouth disease is a common cause of onychomadesis.
Codes
ICD10CM:L60.8 – Other nail disorders
SNOMEDCT:
22743000 – Onychomadesis
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Beau lines – Transverse depressions in the nail plate, considered a less severe form of onychomadesis.
- Retronychia – Proximal ingrowing of nail plate into central surface of proximal nail fold.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:09/26/2017
Last Updated:08/13/2019
Last Updated:08/13/2019
Onychomadesis - Nail and Distal Digit