Onycholysis is a common medical condition characterized by the painless detachment of the nail from the nail bed, usually starting at the tip and/or sides. On the hands, it occurs particularly on the ring finger but can occur on any of the fingernails. It may also happen to toenails. Onycholysis can occur in many conditions, including psoriasis. In thyrotoxicosis, it is thought to be due to sympathetic overactivity. It may also be seen in infections or trauma. Causes
Unknown
Trauma, excessive manicuring
Infection: especially fungal
Skin disease: psoriasis, dermatitis
Impaired peripheral circulation, e.g. Raynauds syndrome
Systemic disease: hyperthyroidism, hypothyroidism, reactive arthritis, porphyria cutanea tarda
Reaction to detergents (e.g. washing dishes with bare hands, using detergent-based shampoos or soaps). Patients with hepatocellular dysfunction may develop hair-thinning or hair loss and nail changes such as clubbing, leukonychia (whitening), or onycholysis, affecting the nails of the hands and feet. Onychomycosis (tinea)
It is common in ballet dancers
Chemotherapy (cytotoxic agents like taxanes, vinca alkaloids and others)
Chronic Renal Failure

Treatment
Most instances of onycholysis without a clear cause will heal spontaneously within a few weeks. The most commonly recommended treatment is to keep the nail dry as much as possible and allow the nail to slowly reattach. Trimming away as much loose nail as can be done comfortably will prevent the nail from being pried upwards. Cleaning under the nail is not recommended as this only serves to separate the nail further. Bandages are also to be avoided.
(S)-Oxybutynin has not been clinically tested for its spasmolytic effects, but may be clinically useful for the same indications as the racemate, without the unpleasant anticholinergic side effects. Brand names
Oxybutynin is available by mouth in generic formulation and under the brand names Ditropan, Lyrinel XL, Ditrospam, Kentera, and Aquiette, as a transdermal patch under the brand name Oxytrol, and as a topical gel under the brand name Gelnique. See also
Arecoline

References
External links
"Oxybutynin". Drug Information Portal. U.S. National Library of Medicine.