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Spontaneous separation of nail plate at its distal end – keratin accumulates under nails.
Occurs at various speeds, but usually slowly. Usually asymptomatic.
Most due to trauma and Candida albicans or Pseudomonas infection.
Could also be due to – excessively long nails (chronic lifting of nail off bed can occur during normal activity); psoriasis (often have pitting as well); dermatitis/eczema; arterial insufficiency; hypothyroidism; congenital nail syndromes; chemicals and nail care products.
Removal of all detached pieces of nail.
and from my medicine notes on hypothyroidism:
Involvement of feet:
Skin can be dry, coarse and scaly – heel fissures common.
Carotenaemia of plantar surface – due to deposition of carotene in lipid rich epidermal layers.
Metatarsophalangeal joints can be affected – insidious onset of pain and stiffness – often worse in morning (symptoms mimic rheumatoid arthritis). Onycholysis.
Depressed deep tendon reflexes with slow relaxation phase
Peripheral neuropathies (eg tarsal tunnel syndrome) may develop (Schwartz et al, 1983) – also can be a distal sensorimotor or sensory distal polyneuropathy – starts as paraesthesia and pain; touch, vibration and proprioception are decreased; the polyneuropathy most commonly start as symmetric numbness in feet
__________________ Craig Payne
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Another cause of onycholysis that I have seen:nail salon syndrome(which is under the category of infection).I also had a CVA pt get it.I remove the nail,no need for P and A.Many nail problems are metabolic in nature.