Onychoschisis L60.85

Splitting of the nail plate from the free edge into two horizontally layered lamellas, one above the other.

Unknown.

Discussed are trauma (playing a plucked instrument), too frequent washing; long-term wearing of occluding gloves (Weistenhöfer W et al. 2017), frequent use of nail polish removers, iron and calcium deficiency.

Frequently also in atopic patients.

Also in systemic diseases such as systemic amyloidosis, polcythaemia vera, HIV infection, glucagonoma syndrome, lichen planus.

Other side effects: EGFR inhibitors, retinoids, penicillamine.

If necessary, remove the cause, file the nails horizontally to reduce the formation of gaps. Cover the nails with self-adhesive materials (e.g. Zalain nail plaster), nail hardeners have also been used with varying degrees of success. The application of artificial nails can be tried. S.a. Nail care.

Overnight greasing ointments or oils (e.g. jojoba oil)

Test with gelatine or biotin containing agents (e.g. Gelacet N) 1 time per day 9 Kps. p.o. over 3 weeks. Afterwards a break of two weeks.

Repetition with 9 Kps. p.o. once/day over 3 weeks.

Maintenance dose over several weeks or months: 3 cps/day. Alternatively e.g. Bio-H-Tin 2,5 mg/day, or e.g. Pantovigar 3 times/day 1 Kps. over 3-6 months.

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