Onychorrhexis - Altmeyers Encyclopedia

Synonym(s)

brittle nails; Nail brittleness; Nail splintering; Nail splinters; Onychisis

Definition
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Dystrophic disorder of nail growth with abnormal brittleness and splintering of the nails with longitudinal fibres.

Occurrence/Epidemiology
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About 10-20% of the population.

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Etiopathogenesis
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Mostly unexplained etiology. Rarely congenital or familial.

Possible exogenous causes: prolonged exposure to water and detergents, contact with alcoholic and fat-dissolving liquids, intensive manicure.

Possible internal causes: hyperthyroidism and hypothyroidism, vitamin A and B deficiency, malnutrition, iron deficiency, calcium deficiency, zinc deficiency.

Manifestation
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Women are more frequently affected than men.

Clinical features
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Tearing, splintering, splitting the nail plate.

Therapy
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Treatment of the underlying disease.

External therapy
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Refatting care, e.g. ammonium lactate-containing external agents (e.g. Kerapil), if necessary masking the brittle nail plate (e.g. Zalain nail plaster); see also Nail care.

Internal therapy
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Try gelatine or biotin-containing products (e.g. Gelacet) 1 time/day 9 capsules p.o. for 3 weeks. Followed by a 2 week break. Then repeat with 1 time/day 9 capsules p.o. over 3 weeks. Maintenance dose over several weeks or months: 3 capsules/day. Alternatively, e.g. Bio-H-Tin 2.5 mg/day, or e.g. Pantovigar 3 times 1 capsule/day for 3-6 months.

If necessary, additional iron or zinc supplementation (e.g. zinc orotate 1 time/day 20 mg p.o.; Ferro sanol duodenal 1 time/day 100 mg p.o.).

Literature
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Chao SC, Lee JY (2002) Brittle nails and dyspareunia as first clues to recurrences of malignant glucagonoma. Br J Dermatol 146: 1071-1074
Fujimoto W et al (2005) Biotin deficiency in an infant fed with amino acid formula. J Dermatol 32: 256-261
Jabbour S (2003) Cutaneous manifestations of endocrine disorders: a guide for dermatologists. At J Clin Dermatol 4: 315-331
Jemec GB et al (1995) Nail abnormalities in nondermatologic patients: prevalence and possible role as diagnostic aids. J Am Acad Dermatol 32: 977-981
Uyttendaele H et al (2003) Brittle nails: pathogenesis and treatment. J Drugs Dermatol 2: 48-49
Fence H (1997) Brittle nails. Objective assessment and therapy follow-up. dermatologist 48: 455-461