By Gary M. White, MD


Onychauxis is thickening of the entire nail plate unassociated with any fungal infection and is common in the geriatric population. Subungual debris and even discoloration may be present. See also aging nails.


The key differential is onychomycosis. Repeated negative scrapings or cultures and even biopsy with PAS staining to exclude fungal infection may be necessary. In the younger population, psoriasis may cause nail thickening resembling onychomycosis.


Electric drills or burrs can thin the plate. Urea paste 40% can chemically thin or avulse the nail.


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