Two case studies of the treatment of simple onycholysis with disappearing nail bed caused by trauma by combined pharmacological, orthonyxia and taping methods.

BACKGROUND: Simple onycholysis is a common complaint after trauma and consists in separation of the nail plate from the nail bed. If untreated, prolonged onycholysis may cause a disappearing nail bed (DNB) that leads to the shortening or narrowing of the nail plate. OBJECTIVES: This study is aimed at discussing possible treatment of chronic simple onycholysis with DNB by combined conservative methods. METHODS: Simple onycholysis and DNB treatment consists of Onygen® cream application, nail bed massages, bracing procedures and nail folds taping with kinesio tape. RESULTS: Long-lasting simple onycholysis with DNB may be fully eliminated by applying the combined pharmacological, orthonyxia and taping treatment. CONCLUSION: Advanced simple onycholysis, which leads to the DNB and, in consequence, to the shortening or narrowing of the nail plate, causes cosmetic discomfort for patients. A damaged nail apparatus is also more susceptible to new traumas. Even long-standing onycholysis with DNB can be successfully treated with easy-to-apply conservative methods. The key point of therapy is the use of several methods of treatment with different effects on the nail apparatus. The effects of described therapy are highly satisfactory, the only drawback being its long term, which is caused by slow growth of the nails.

A double-blind, randomised trial of a polyphenolic-rich nail bed balm for chemotherapy-induced onycholysis: the UK polybalm study.

PURPOSE: Nail damage is common amongst patients receiving chemotherapy causing disfigurement and pain. This investigation evaluated whether a topical balm containing steam-extracted, bioactive polyphenolic-rich herbal oils blended with organic waxes could protect the nails via their reported anti-inflammatory, analgesic, anti-oxidant and anti-microbial properties. METHODS: 60 patients (23M, 37F) were randomised to apply (2-3/day) either the plant balm (PB) or a petroleum control (PC) to their nail beds. Demographics, type and number of chemotherapy cycles did not differ between the two groups, recruited between Sept 2015 and Sept 2016. An unpaired t test was used to test the differences in symptoms and physical nail damage between the two groups. RESULTS: Symptom scores recorded with the dermatology life quality questionnaire (DLQQ) were significantly better, between the start and end of chemotherapy, in the group applying the PB versus PC. Likewise, the mean fall in nail damage, scored with the Nail Psoriasis Index by the supervising physician, was also significantly different. CONCLUSION: The polyphenolic-rich essential oils and plant-based waxes in this nail bed balm profoundly reduced chemotherapy-related nail damage and improved nail-related quality of life, compared to a control. A further analysis is planned combining this balm with nail bed cooling.

Painful nail lesions.

A man, 58 years of age, presented with a 4 year history of painful lesions of his nails. His previous history included hypertension, diabetes mellitus and hyperlipidaemia. These were treated with enalapril, metformin and simvastatin respectively. He also had asymptomatic skin lesions for over 15 years that had worsened in the past 4 years. His father had similar nail lesions that had been diagnosed as onychomycosis.