Nails Health

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Nails provide a number of important clues towards the diagnosis of a systemic illness.

It is therefore necessary to know some of the common abnormalities of nails in children and adults.

1.KOILONYCHIA

Concave thin nails with everted edges shaped like a spoon and Fingernails, +/- toenails.

CAUSES:

• Iron deficiency anemia

• Hemochromatosis

• Occupational trauma

• Coronary disease

• Hyperthyroidism

• Normal children - 1st 2 year of life
  LEUKONYCHIA

2.PUNCTATE LEUKONYCHIA

White opacity of nail plate that may involve entire plate or may be punctate or striate

CAUSES:

• Traumatic

• Leprosy

• Tuberculosis

• Lichen planus

• Darier disease

• Hodgkin disease

• Anemia

3.TERRY NAILS

White ground-glass appearance of entire or proximal end of nail and a normal pink distal 1-2 mm of nail

CAUSES:

• Cirrhosis of liver

• Chronic congestive heart failure

• Adult onset diabetes mellitus

• Normal in children < 4 yr old.

4.MEES LINES

Single white transverse bands

CAUSES:

• Arsenic poisoning

• Chronic kidney disease

• Carbon monoxide poisoning

• After chemotherapy

5.MUEHRCKE LINES

Paired parallel white transverse bands (without furrowing). These do not change position with nail growth

CAUSES:

• Hypoalbuminemia

• Nephrotic syndrome

• Glomerulonephritis

• Liver disease

• Malnutrition

6.HALF-AND-HALF OR LINDSAY NAILS

The Proximal half of the nail is white and the distal half is pink or reddish brown.

CAUSES:

• Renal disease associated with azotemia

-Hemodialysis patient

• Renal transplant recipients

• HIV patient

• Normal variant.

7.SPLINTER HEMORRHAGES

Fine longitudinal non-blanching hemorrhagic streaks under the nail plate.

CAUSES:

• Subacute bacterial endocarditis

• Vasculitis

• Langerhans cell histiocytosis

• Hypertension

• Scurvy

• Trichinosis

• Psoriasis

8.ONYCHOLYSIS

Distal separation of nail plate from underlying nail bed.

CAUSES

• Long-term exposure to moisture

• Psoriasis

• Fungal infection (distal onychomycosis)

• Atopic or Contact dermatitis

• Hyperthyroidism

• SLE

• Pellagra

9.ONYCHOMADESIS

Proximal nail bed separation with eventual shedding of nails

CAUSES:

• Trauma

• Poor nutritional status

• Febrile illness

• Drug sensitivity

• Kawasaki disease

• Hand foot and mouth disease

10.BEAU'S LINES

Transverse furrows in nail plate

due temporary arrest of nail growth at times of biological stress

CAUSES:

• Poor nutritional status

• Febrile illness

• Hand-foot-and-mouth disease

• Measles

11.HABIT TIC DEFORMITY

• Habitual external trauma to nail matrix.

• Constant pushing of cuticle results in nail matrix damage.

• Manifests as series of transverse depression from proximal to distal end of nail.

• One or both thumbs usually involved

• Zinc deficiency

12.NAIL BITING/ONYCHOPHAGIA

Can lead to irreversibly shortened nails, paronychia, ragged cuticle, and hang nails

CAUSES:

• Obsessive-compulsive disorder

• Anxiety disorder

13.CLUBBING (HIPPOCRATIC NAILS)

Increased transverse and longitudinal nail curvature of nails. Swelling of each distal digit with a spongy feeling.

Lovibond's angle > 180 degrees.

• Bronchiectasis

• Empyema

• Lung abscess

• Cyanotic congenital heart disease

• Subacute bacterial

• endocarditis

• Celiac disease

• Inflammatory bowel disease

• Cirrhosis

14.ACUTE PARONYCHIA

Acute inflammation (erythema, warmth, edema, and tenderness) of proximal nail fold

CAUSES:

• Staphylococci, streptococci, or Candida infection

• Nail biting

• Thumb or finger sucking

15.CHRONIC PARONYCHIA

Chronic infection of nail fold (candida & mixed bacterial flora). Painful erythema withintermittent discharge

CAUSES:

• Finger or thumb sucking

• Nail biting

• Raynaud phenomenon

• Collagen vascular diseases

• Diabetes

INGROWING NAIL

16.INGROWING NAIL

Lateral edge of nail (great toe) penetrates soft tissue of lateral nail fold. Erythema, edema, and pain.

Recurrent episodes lead to granulation tissue formation

CAUSES:

• Congenital malalignment of great -toes

• Compression by poorly fitting shoes

• Improper cutting of nail in a curvilinear manner

17.MELANONYCHIA STRIATA

• Black pigmentation of an entire nail plate or linear bands of pigmentation

• Pigment is melanin produced by melanocytes of a junctional nevus in nail matrix and nail bed

• Extension or alteration in pigment may occur due to malignant change.

18.BLUISH BLACK TO GREENISH NAILS

GREEN-BLACK DISCOLORATION AT EDGE OF NAIL

• Pseudomonas infection

• Coloration is due to subungual debris and pyocyanin pigment from bacteria

19.YELLOW NAIL SYNDROME

Nail plate is discolored green yellow.

Nails are hard with elevated longitudinal curvature. Nails may shed, and are painful

CAUSES:

• Bronchiectasis

• Lymphoedema

• Chronic sinusitis

20.ONYCHOMYCOSIS

Fungal infection of the nails

• Discoloration, hyperkeratosis and crumbling of nail

21.PERIUNGUAL FIBROMAS

• Tuberous sclerosis

22.TRACHYONYCHIA

• Longitudinal ridging, pitting, fragility, thinning, distal notching and opalescent discoloration of all nails.

CAUSES:

• Lichen planus

• Psoriasis

• Eczema

According to established sources there are about 22 types of nail deceases which are shared above with causes.

I don't recommend any self treatment as it is very difficult to differentiate one symptom from another. Anyways one should consider Healthy diet and do padicure and manicure in regular intervals. Always use nail cutter for safety.

However I had an accidental damage of nail which I treated according to the doctor's advice. Once my foot nail become dark which disappeared with blood sugar control. Recently when I wore a shoe I had blood clots in nail with pain.

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