Differential Diagnosis for Nails Falling Off
Single Most Likely Diagnosis
- Onychomadesis: This is a condition where the nails fall off due to a temporary interruption in nail growth, often caused by a systemic illness, infection, or trauma. The timing of 4 weeks is consistent with the typical onset of onychomadesis after a triggering event.
Other Likely Diagnoses
- Fungal infections (onychomycosis): These can cause nail loosening and eventual loss, especially if left untreated. The infection can spread from one nail to another.
- Psoriasis: Nail psoriasis can lead to nail detachment and loss due to the inflammatory changes in the nail bed and matrix.
- Trauma: Direct injury to the nails can cause them to fall off, especially if the trauma is severe enough to disrupt the nail plate from the nail bed.
Do Not Miss Diagnoses
- Alopecia Areata: Although primarily known for causing hair loss, alopecia areata can also affect the nails, leading to nail loss among other nail changes. Missing this diagnosis could delay treatment for a potentially autoimmune condition.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause nail changes, including nail loss. These conditions require medical intervention to prevent long-term complications.
- Sarcoidosis: This systemic disease can cause nail changes, including nail loss, as part of its broader spectrum of symptoms affecting various organs.
Rare Diagnoses
- Pemphigus: A group of autoimmune diseases that can cause blistering of the skin and mucous membranes, and in some cases, nail loss.
- Lichen Planus: An inflammatory condition that can affect the skin, mouth, and other areas, sometimes leading to nail changes and loss.
- Darier's Disease: A rare genetic disorder that affects the skin and sometimes the nails, leading to abnormalities including nail loss.