Onychauxis

Dr Information

Summary – Thickening of the entire nail plate with transverse ridging. Often associated with mycotic infection or pressure from footwear. Can also present in association with onychogryphosis and onycholysis.
Literature – Keratin produced by matrix at uneven rates, with faster growing site dertermining the direction of deformity.
Diagnostic tip – Short trial (6 weeks, twice daily application) of topical terbinafine hydrochloride cream/spray in conjunction with debulking can rule out mycosis.
Testing or imagery – If severe mycotic infection suspected and oral terbinafine recommended, nail scrapings and culture can be relevant.
Referrals – Refer to podiatrist for conservative management and possible treatment of underlying cause.

Patient Information

Summary – Thickening of nails.
How does this occur? – Trauma, poor peripheral circulation or fungal infection.
How can this be helped? – Debulking of the nail, treatment of infection, regular management.
Who can help? – Podiatrist – debulking, treatment of infection. GP – check for onychomycosis as cause and treat with oral antifungal agents if appropriate for patient.