Long Sloan, Harris Peyton, Youssef Ronnie, Furukawa Betsy
Texas A&M School of Medicine, Dallas, Texas, USA.
Department of Dermatology, Baylor Scott and White Medical Center - Temple, Temple, Texas, USA.
Proc (Bayl Univ Med Cent). 2025 Feb 27;38(5):762-764. doi: 10.1080/08998280.2025.2466364. eCollection 2025.
Onycholysis is a disorder of the nails, described as the separation of the nail bed from the nail plate. While onycholysis most commonly occurs due to trauma to the nail, such as after manicures or chemical exposure, it can also result from drug-induced photosensitivity. Many medications have been linked to onycholysis, including tetracyclines, psoralens, and retinoids, which are synthetic derivatives of vitamin A. Oral retinoid use has been associated with various nail changes, but there are no reports of onycholysis resulting from oral vitamin A intake. Thus, we present the case of an 85-year-old woman who presented with distal onycholysis to the fingernails, described as lifting of ends. She was prescribed a 5-day course of 10,000 units of vitamin A twice daily after a lumbar laminectomy; however, she continued over-the-counter vitamin A supplementation for 2 months after prescription completion. Given this patient's history of prolonged vitamin A intake, her symptom improvement upon supplement cessation, and the documented reports of other nail changes caused by vitamin A derivatives and isotretinoin, we believe that onycholysis is an unreported adverse effect of vitamin A therapy.
甲剥离是一种指甲疾病，表现为甲床与甲板分离。虽然甲剥离最常见的原因是指甲受到外伤，如修甲或接触化学物质后，但也可能由药物引起的光敏反应导致。许多药物都与甲剥离有关，包括四环素、补骨脂素和类维生素A（维生素A的合成衍生物）。口服类维生素A与各种指甲变化有关，但尚无因口服维生素A导致甲剥离的报道。因此，我们报告一例85岁女性患者，其手指甲出现远端甲剥离，表现为指甲末端翘起。她在接受腰椎椎板切除术后，被开了一个疗程，为期5天，每天两次，每次10000单位的维生素A；然而，在处方疗程结束后，她又继续服用非处方维生素A补充剂达2个月。鉴于该患者长期摄入维生素A的病史、停用补充剂后症状改善，以及有文献报道维生素A衍生物和异维A酸会引起其他指甲变化，我们认为甲剥离是维生素A治疗一种未被报道的不良反应。
