Pattern diagnosis of onycholysis

Abstract

Onycholysis is defined as the detachment of the nail plate from the underlying and/or lateral supporting structures. Trauma, inflammatory conditions, infectious agents, tumours and toxic substances are the most commonly reported causes of onycholysis. We review the main causes of onycholysis in clinical practice and provide a diagnostic approach based on morphologic patterns of the proximal border of onycholysis, as defined by clinical and dermoscopic examination. Four morphologic patterns of onycholysis, namely transversal, lateral, V-shaped and circular are presented with their most common causes and triggers.