Intermittent onycholysis in young girl
The nail then separates from the nail bed and slowly falls off. Cultures for bacterial and fungal infection have been negative. Trials of topical antifungal creams have made no difference. No other nails are involved.
This is a condition called parakeratosis pustulosa, typically seen on single digits in young females. It is probably a variant of localised pustular psoriasis, although some people consider it an eczema variant. It will respond to a strong topical steroid cream applied to the nail