Combination urea and salicyclic acid ointment nail avulsion in nondystrophic nails: a follow-up observation.

Following the initial report by Farber and South on nonsurgical nail avulsion with urea ointment and their emphasis that the therapy was not helpful in treating nondystrophic nails, we utilized a similar therapy to treat a sixty-seven year old patient who had severe arteriosclerotic cardiovascular disease and relatively nondystrophic but symptomatic large toenail disease. Because their formulation was ineffective on nondystrophic nails, a formulation with an additive, 20 percent urea and 10 percent salicylic acid preparation was used. After a period of two weeks of occlusive paplication, painless nonsurgical avulsion was achieved. Moderate maceration of surrounding skin was temporary and relatively asymptomatic.