Onychomadesis

The complete shedding or loss of a nail from the nail bed, beginning at the proximal nail fold near the cuticle, caused by temporary interruption of nail matrix activity resulting in separation of the nail plate from the matrix.

Causes

• Infections

  • Hand, foot, and mouth disease (enteroviruses, especially coxsackievirus)

  • Chickenpox (varicella-zoster virus)

  • Severe systemic infections causing temporary nail matrix arrest

• Trauma: Direct injury or crushing of the nail bed or matrix, tight footwear

• Medication-related causes

  • Chemotherapy

  • Antiepileptic medications

  • Retinoids

• Systemic illness and inflammatory causes

  • High fever

  • Severe metabolic stress

  • Critical illness

  • Kawasaki disease

  • Autoimmune blistering diseases: Pemphigus vulgaris

  • Severe inflammatory conditions

• Malnutrition or severe nutritional deficiency