๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
ONYCHOLYSIS
ONYCHOLYSISย ย ICD-10: L60.1
โข Lifting of the nail plate from the nail bed (Fig. 32-3).
โข Etiology
โข Inflammatory: Psoriasis (Fig. 32-3), contact dermatitis, photodrug reaction (doxycycline, fluoroquinolones, griseofulvin, voriconazole).
โข Infection (Candida).
โข Trauma.
โข Nail bed tumors.
โข Can become secondary infected with P. aeruginosa, causing a brown or greenish discoloration (Fig. 32-4).
โข Management: For inflammatory causes, can treat with topical steroid solution (apply under nail) or intralesional steroids. Can also consider systemic therapies for psoriatic onychloysis. Prescribe antifungals for onycholysis secondary to a yeast infection.
A B
FIGURE 32-3 โข OnycholysisโA 60-year-old female with distal onycholysis of fingernails, mild chronic paronychia, and loss of cuticle. Psoriasis is the likely underlying problem.
FIGURE 32-4 โข Onycholysis with Pseudomonas colonizationโ(A) Psoriasis has resulted in distal onycholysis of the thumbnail. (B) Infection with Pseudomonas aeruginosa has produced the green-black discoloration of the undersurface of the onycholytic nail.