Onychomadesis

Aka: Onychomadesis

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II. Definitions

  1. Onychomadesis
    1. Spontaneous shedding/sloughing and separation of nail plate from nail matrix resulting in nail loss
  2. Onycholysis
    1. Spontaneous separation of nail plate from nail bed (typically starting from distal end)

III. Epidemiology

  1. Uncommon

IV. Pathophysiology

  1. Temporary cessation of nail matrix growth
  2. Results in Nail Dystrophy and nail loss

V. Signs

  1. Brittle nails
  2. Nail bed region may have white or yellow streaks
  3. Transverse nail splitting
  4. Nail appears to peal away from nail bed
  5. Spontaneous loss of multiple nails

VI. Causes

  1. Post-infectious in first 3-12 weeks (esp. Coxsackie virus such as Hand Foot and Mouth Disease)
  2. Kawasaki Disease
  3. Nail Trauma
  4. Chemotherapy
  5. Radiation Therapy

VII. Differential Diagnosis

  1. See Nail Disorders
  2. Onycholysis

VIII. Prognosis

  1. Normal Nail Growth resumes within 1 to 4 months

IX. References

  1. Jhun, Raam and DeClerck in Herbert (2015) EM:Rap 15(12): 3-4
  2. Metzgar (2019) Am Fam Physician 100(8): 497-8 [PubMed]

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