Sterile Matrix Grafting for Onycholysis in the Setting of Valproic Acid Use

The document reported on a case of a 26-year-old woman with onycholysis and dorsal pterygium linked to long-term valproic acid (VPA) use. The study proposed sterile matrix grafting as a surgical solution for nail nonadherence caused by VPA, which is an antiepileptic drug known to cause various nail deformities. The patient underwent a successful surgical procedure involving the excision of scarred sterile matrix and grafting from the great toe, resulting in well-healed nail adherence and minimal donor site morbidity after 17 months. The study concluded that sterile matrix grafting could be an effective intervention for patients who cannot discontinue VPA therapy.