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Onycholysis Workup

  • Author: Melanie S Hecker, MD, MBA; Chief Editor: William D James, MD  more...
 
Updated: Feb 09, 2016
 

Laboratory Studies

Perform mycologic studies to exclude onychomycosis, including potassium hydroxide wet mount and fungal cultures. If these studies do not yield a positive result, a nail biopsy and staining of the specimen with hematoxylin and eosin stain and periodic acid-Schiff (PAS) stain (for fungus) may be performed.

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Histologic Findings

Onycholysis is a clinical diagnosis and has no specific histology; however, if onychomycosis is the etiology for the onycholysis, hyphae are seen lying between the laminae of nail parallel to the surface. The ventral nail and the stratum corneum of the nail bed are affected preferentially. The epidermis may show spongiosis and focal parakeratosis. The inflammatory response in the dermis is minimal. Hyphae may be seen best using PAS stain.

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Contributor Information and Disclosures
Author

Melanie S Hecker, MD, MBA President, Hecker Dermatology Group; Consulting Staff, Department of Dermatology, Imperial Point Medical Center, Holy Cross Hospital, and North Broward Hospital

Melanie S Hecker, MD, MBA is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Medical Society of the State of New York

Disclosure: Nothing to disclose.

Coauthor(s)

David Hecker, MD Consulting Staff, Dermatology Specialists of Palm Beach County

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD Associate Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Richard K Scher, MD Adjunct Professor of Dermatology, University of North Carolina at Chapel Hill School of Medicine; Professor Emeritus of Dermatology, Columbia University College of Physicians and Surgeons

Richard K Scher, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American Medical Association, Association of Military Surgeons of the US, International Society for Dermatologic Surgery, Noah Worcester Dermatological Society, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

References
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  13. Oram Y, Karincaoglu Y, Koyuncu E, Kaharaman F. Pulsed Dye Laser in the Treatment of Nail Psoriasis. Dermatol Surg. 2010 Jan 19. [Medline].

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  15. Scotte F, Banu E, Medioni J, et al. Matched case-control phase 2 study to evaluate the use of a frozen sock to prevent docetaxel-induced onycholysis and cutaneous toxicity of the foot. Cancer. 2008 Apr 1. 112(7):1625-31. [Medline].

  16. Scotte F, Tourani JM, Banu E, et al. Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand. J Clin Oncol. 2005 Jul 1. 23(19):4424-9. [Medline].

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