Primary onycholysis of the big toenails: a review of 113 cases

We have reviewed the clinical and microbiological features of 113 cases of idiopathic onycholysis primarily affecting the great toenails. It is suggested that the majority of these cases were traumatic in origin. Although dermatophytes and potentially pathogenic bacteria were frequently found in the lesions, they were thought to be commensal in most cases. This is of considerable significance with regard to the selection of appropriate therapy.