Wednesday, May 17, 2006

Onycholysis

The patient is a healthy 58 year old woman with a 3 year history of onycholysis. Fungal culture has grown out Candida zeylanoides. Bacterial culture negative.

Topicals have not been of help. (imidazoles and thymol in chloroform)
Would fluconazole be of value?
Should the nail be avulsed?
Who has had success treating this kind of problem?

4 comments:

  1. AnonymousMay 18, 2006

    Use 10% sulfacetamide ophth sol or Klaron to get rid of the pseudomonas, it'll look better. The lateral ridging of the nail would make me consider trauma. If the thumb is on the dominant hand, its often used as a tool. Lastly, trim it short. It's at risk for injury and chronic onycholysis from lifting. Keep her hands dry. DW Johnson, Honolulu

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  2. AnonymousMay 18, 2006

    The nail clinically looks like a pseudomonas infection with the yellow-green appearance. We use gentimicin ophthalmic drops TID into the nail. The candida albicans -- it may be superinfected with candida. Sporanox or diflucan works better than PO lamisil. Would probably try just the gentimicin drops initially. - Phung

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  3. The nail plate looks apparetly healthy.The discoloration under the seperated nail is a dirt with bacterial colonisation.This pictuer is in favour of house wife onycholysis.Wearing protective gloves and cutting the seperated nail and appling topical anibiotics and nystatin is enough.
    khalifa sharquie Sharquie IK, Al-Faham M, Karhoot JM, Sharquie KE, Al-Waiz MM, Al-Douri WS. Related Articles, Links
    Housewife onycholysis.
    Saudi Med J. 2005 Sep;26(9):1439-41.

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  4. This is relatively common nail problems. Many causes were reported, but the housewife dermatitis is the commenest one caused by the following:
    1-Trauma(mechanical, physical or chemicals).
    2-secondary colonization as a cofactor.
    So can be managed by:
    1- drying & avoid trauma.
    2- Acetic acid compress.
    3- spectenomycin.
    4- Affected part of the nail shoud be kept clipped away.


    Alkubaisi thamir

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