Diseases of the Nails #7
Distal onycholysis refers to spontaneous separation of the nail plate starting at the distal free margin and progressing proximally. Local irritation is the most common insult, such as excessive filing or chemical overexposure in manicures. Onycholysis has also been associated with a number of other systemic disorders, specifically systemic lupus erythematosus, hyperthyroidism, iron-deficiency anemia, primary dermatologic diseases (such as atopic dermatitis and psoriasis vulgaris), or neoplasms (including squamous cell carcinoma and lung carcinoma), as well as medications (especially fluoroquinolones and doxycycline), infections, or congenital etiologies. Patients do not typically report any pain or discomfort unless there is a superimposed infection. Treatment involves controlling or eliminating any risk factors and clipping off the unattached nail to prevent additional prying off and to allow for normal replacement of nail growth. Image courtesy of the National Institutes of Health.
http://www.medscape.com/features/slideshow/nail-diseases?src=nl_slide
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