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Hi All,

Just wondering if anyone has seen this...

Proximal onycholysis! I had a patient this afternoon with the proximal 1/3 onycholytic, but the O/L went only about 2/3 across the nail from medial to lateral. The patient does not recall any specific trauma except possibly tight dress shoes worn on a night out. There is no remarkable medical history, 35 year old male, no medications, no pain... He reports that it was bruised maybe 6 months ago, the nail came off proximally to distally and grew back this way...

Anywho I have resected the nail to clear the O/L and see what was underneath, and it's just normal skin...no new nail, and it doesn't even look like there's going to be any new nail growing back... is it possible that it might still grow back? How long might it take for a new nail to start to show? It just seems really weird to me as I have only ever seen O/L distally before this...

Any ideas?

Regards

Donna :)

Try a Google search for Onychomadesis

__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

Thanks for that CP!

I'll have to keep an eye on him and see how things go... the pictures on the Google search do look similar, except not as brittle looking... oh and I forgot to mention it was only the single offender in the right 1st toenail I probably gave the impression it was all the toenails... hmmm... so sorry about that!

Thanks again!:)

Regards

Donna

Hi Donna,
I had a patient who had onychomadesis, accompanied by onychocryptosis at both sulci of the left hallux nail. I conducted a total nail avulsion with phenolisation of both nail edges to prevent recurrence of the ingrowing. When the visible nail was removed, I was surprised to find another nail underneath .
Now the non-phenolised section of the nail has regrown without any onychomadesis :).
Sorry I know this is a bit different to your case, but I just thought it was interesting.
Kind regards, Beth.

Hi Beth,

Thanks for that info... I haven't yet reviewed the patient, he reported no pain and no new nail (after removing the onycholytic part) when I checked on him 1 week post treatment. I guess it's one of those "wait and see" cases, I don't have the magical power of being able to predict nail growth... :p

Regards

Donna