Onycholysis

The distal separation and loosening of the nail plate from the underlying nail bed, typically beginning at the free edge and progressing proximally.

Causes

• Trauma

• Environmental and irritant causes

  • Prolonged moisture exposure

  • Contact with detergents or chemicals

  • Solvents and nail products

• Infectious causes

  • Fungal infection (onychomycosis)

  • Bacterial nail infection

  • Pseudomonas infection (“green nail syndrome”)

• Inflammatory and dermatological causes

  • Psoriasis

  • Eczema

  • Contact dermatitis

  • Lichen planus

• Medications

  • Drug-induced photosensitivity: Tetracyclines

  • Chemotherapy agents

  • Retinoids

• Endocrine and metabolic causes

  • Hypothyroidism

  • Hyperthyroidism

  • Diabetes mellitus

• Nutritional and systemic causes

  • Iron deficiency anemia

  • Nutritional deficiencies

  • Systemic inflammatory diseases

  • Connective tissue disorders

• Aging-related nail changes