Onycholysis Clinical Presentation

Updated: Nov 20, 2020
  • Author: Melanie S Hecker, MD, MBA; Chief Editor: William D James, MD  more...
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Evaluation of patients with onycholysis requires a careful history of exposure to etiologic agents.


Physical Examination

In onycholysis, nails are smooth, firm, and without inflammatory reaction.

Discoloration underneath the nail may occur as a result of secondary infection.

Spontaneous separation of the nail plate in onycholysis starts at the distal free margin and progresses proximally. Less often, nail plate separation may begin at the proximal nail and extend to the free edge. The nail plate is separated from underlying and/or lateral supporting structures.

Nail plate separation can be confined to the nail's lateral borders (rare).