Onychauxis

Onychauxis
Onychauxis
	Onychauxis
Specialty	Medical genetics

Onychauxis presents with thickened nails without deformity, and this simple thickening may be the result of trauma, acromegaly, Darier's disease, psoriasis, or pityriasis rubra pilaris, or, in some cases, hereditary.^[1]^: 783^[2]

It may appear as loss of nail palate translucency, discoloration, and subungual hyperkeratosis. Complications include pain, distal onycholysis, subungual bleeding, subungual ulceration, and onychomycosis.

Treatment includes debridement of the nail plate, urea pastes, electric drills, nail avulsion, and chemical or surgical matricectomy.

Signs and symptoms

Onychauxis frequently shows up clinically as discoloration, subungual hyperkeratosis, and loss of nail plate translucency.^[3] It may cause pain, and over time, distal onycholysis, subungual bleeding, subungual ulceration, or an elevated risk of onychomycosis might aggravate matters.^[4]^[5]

Causes

Growing older or having poor biomechanics, which are more common in the elderly (e.g., toes that overlap and underlap; incompatibility between the foot and the shoe; or digiti flexi, which is characterized by contracted toes due to toe buckling caused by shortening of the controlling muscles), may be contributing factors.^[3]

Treatment

The recommended first treatment is periodic partial or complete debridement of the thickening nail plate. Other potential treatments that could be helpful are urea pastes with a 40% or greater concentration, electric drills, and nail avulsion. In complex situations or those with recurrences, chemical or surgical matricectomy may be used as a last resort to accomplish permanent ablation of the affected nail plate.^[3]

References

^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
^ ^a ^b ^c Abdullah, Lina; Abbas, Ossama (2024-03-14). "Common nail changes and disorders in older people: Diagnosis and management". Canadian Family Physician. 57 (2). College of Family Physicians of Canada: 173–181. PMC 3038811. PMID 21321168.
^ Cohen, Philip R.; Scher, Richard K. (1992). "Geriatric nail disorders: Diagnosis and treatment". Journal of the American Academy of Dermatology. 26 (4). Elsevier BV: 521–531. doi:10.1016/0190-9622(92)70075-q. ISSN 0190-9622. PMID 1597537.
^ Singh, Gurcharan; Haneef, NayeemSadath; A, Uday (2005). "Nail changes and disorders among the elderly". Indian Journal of Dermatology, Venereology and Leprology. 71 (6). Scientific Scholar: 386–392. doi:10.4103/0378-6323.18941. ISSN 0378-6323. PMID 16394478.