Drug Induced Onycholysis

Drug-induced onycholysis is a rare, unpredictable, but severe event, whose pain and discomfort is hardly affordable, impairing manual activities or ambulation. Patient's quality of life might be severely compromised, and correct patient information is mandatory before starting any therapy potentially able to cause it. The course is favorable, with spontaneous remission with drug withdrawal, but complete recovery might take several months due to the slow nail growth rate. Aim of this review is to arouse medical attention on this peculiar type of drug adverse reaction, listing current medications reported as more or less frequent culprit, to recognize the challenge and manage it properly. Patient awareness is critical to prevent and immediately counter act the changes, as well as avoid possible favoring factors, such as contact irritants, trauma, and moisture. Another important issue is recognizing and reporting new observations, as the constant introduction of new drugs will definitely increase the list of possible offending medications.