Nail Diseases
Nail Diseases , The nail is an epidermis formation that is located on the outer surface of the tips of our fingers and facilitates the holding of objects and provides support to the fingertips .
The tab is rectangular and convex outward. It has a hard and translucent structure. It consists of 100-150 corneocyte layers with a thickness of 0.5¬0.7 mm.
The nail grows on the nail bed. The light colored area on the nail shaped like a half moon is called “lunula”. In a healthy person, nails grow by 0.9 mm per week.
The growth rates of each hand and each finger are different. It has been observed that it grows rapidly in diseases such as psoriasis, and slowly in lichen planus.
What are the Types of Nail Diseases?
Spoon Nail (Koilonychia)
- Nail resembles a spoon with its concave shape. There are reasons that cause thinning of the nail.
- It can be seen on the toes of children and usually improves with age.
- The form seen in older ages is irreversible.
- Many of the systemic causes , is more common local causes. It can be seen normally in early childhood.
- Congenital , It may be caused by trichotiodystrophy, ectodermal dysplasia, nail patella syndrome, acromegaly, coronary disorders.
Pincer Nail
- The convexity of the nail has increased considerably, the nail becomes a rotating roll within itself, often sinking into the nail bed with narrowed nail edges.
- Beta blocker drugs, psoriasis, tight shoes, bone tumors, subungual exocytosis, osteoarthritis, fungal infection, except for soft tissue tumors, may be genetic causes, especially in all fingers.
- Recurrent infections, shoe hitting and pain are the most important complaints. In the treatment, substances containing urea can be given to soften the nail.
- It can use some spring-loaded apparatus that corrects gradually. The nail can be cauterized so that it does not come out completely.
- Sometimes, the nail bed can be surgically corrected to ensure that the nail grows properly.
Racket Nail (Brachyonychia)
- The most extreme bone of the thumb (distal phalanx) is wider and shorter than normal, so the nail bed is also very short.
- It is not usually related to a disease. It is an inherited condition that is more common in women.
Nail Fungus (Onychomycosis)
- T iRNAi fungal infections , mainly formed by organisms dermatophydid given name.
- It is an infection that affects the nail bed and plate. It accounts for about 50% of all nail disease.
Onychogryphosis
- The outer parts of the nail turn and thicken in the nail bed, coarse and hard, hence the name claw nail. It can be in the form of a horn or a beak.
- This problem most commonly occurs in the big toe. It is very common in the elderly. Although the patient usually does not accept it, the inability of the patient to cut his nail is an important factor.
- Circulatory disorders are more common in those with anatomical disorders such as hallux valgus and those with keratinization disorders. It may be due to chronic trauma and completely idiopathic.
Horizontal Stripes on The Nail (Beau)
- These horizontal grooves in the nail represent a disruption in the growth of the nail.
- Its depth and width give clues about the situation.
- Operations, stress, allergic diseases, medications, infections such as scarlet fever, measles, typhus and sometimes diseases such as pellagra, SLE, pustular psoriasis and trauma may be the cause of these lines.
Stratification of Nails (Onychochisia)
- It is the separation of the tips of the nails into layers like diamond dough.
- It is seen in some blood diseases (polycythemia), AIDS disease and some pancreatic diseases (glucagonoma).
- Frequent wetting and drying of the nails also occur with nail polish, acetone, excessive cuticle and trauma.
White Spots on The Nail (Leukoniki)
- Partially or whole nail, in the form of dots or lines, at birth or later.
- It can be seen due to tuberculosis, nephritis, lymphoma, frostbite injury, cancer metastases, typhoid fever, cirrhosis, leprosy, ulcerative colitis, nail biting, use of cancer drugs, hard cuticle.
Onychophagia (Nail Eating)
- It is a condition characterized by playing with the nail, biting and plucking the skin at the base of the nail.
- It is common due to psychological stress.
Splinter Bleeding
- In the nail bed, they are 2¬3mm longitudinal bleeding lines as if the splinter had sunk.
- If it is on a single finger or very faint, it is not a typical finding.
- It is most commonly seen in bacterial endocarditis (inflammation of the pericardium), in Raynould’s disease, Antiphospholipid syndrome, Collagen and vascular diseases, hypertensive patients, rheumatoid arthritis and mitral valve stenosis, hemodialysis patients and psoriasis, nail fungus, scurvy, eczema, pemphigus.
- It is usually seen at the tip, but in onychomatrixoma, a nail bed tumor, hemorrhage is seen at the bottom of the nail.
Ingrown Toenails
- Nails are normally formed in the nail root, under the skin called the germinal matrix, and grow forward on the upper part of the finger, which we call the nail bed.
- Sometimes the nail tips sink into the skin from the sides and start a reaction like a foreign body, sometimes the nail may become completely sunken into the nail bed, not just in the corners. In both cases, the first signs are pain and swelling.
- There may be bleeding in the stinging area or inflammation may develop due to infection.
- Putting on shoes and walking can be very difficult. If left untreated, progression of inflammation to the bone (osteomyelitis) and systemic infections may occur.
- Especially in diabetic patients, such inflammation may be the reason for the loss of the finger or even the foot with late treatment.
Frequently Asked Questions About Nail Diseases
What are nail diseases and what causes them to develop?
Nail diseases are medical conditions affecting the structure, growth, or appearance of fingernails and toenails. They can be triggered by a wide range of factors, including fungal or bacterial infections, physical trauma, repetitive stress from tight footwear, and poor systemic circulation. Additionally, underlying systemic health issues like psoriasis, eczema, anemia, thyroid disease, or diabetes frequently manifest as noticeable abnormalities in the nails.
What is the most common nail disease and how do you treat it?
The most common nail disease is onychomycosis, widely known as a fungal nail infection. It causes nails to become thick, brittle, ragged, and discolored, typically turning yellow, brown, or white. Treatment options depend on severity and include over-the-counter topical antifungal ointments, prescription oral antifungal medications, and specialized laser therapy to eliminate the fungus safely without damaging surrounding tissue.
Why do nails develop abnormal ridges, splits, or brittle textures?
Abnormal nail textures can stem from both external habits and internal health factors. Vertical ridges are often a completely harmless sign of natural aging or chronic dryness. However, severe splitting, peeling, or brittleness (onychoschizia) usually points to frequent exposure to harsh chemicals, over-wetting, or nutritional deficiencies in vitamins and minerals like iron, zinc, and biotin. Horizontal ridges, known as Beau’s lines, indicate a past severe illness or high physical stress that temporarily halted nail growth.
What causes an ingrown toenail and how can it be prevented?
An ingrown toenail (onychocryptosis) occurs when the sharp edge or corner of the nail grows directly into the surrounding skin fold, causing intense pain, swelling, and bacterial infection. The primary causes include trimming nails in a rounded shape instead of cutting them straight across, wearing shoes that compress the toes, or sustaining a direct injury. Prevention involves proper nail-trimming habits and wearing footwear with a wide toe box.
Can white spots or dark lines on your nails signal a serious health issue?
Isolated white spots (leukonychia) are usually harmless and result from minor, forgotten matrix trauma. However, dark lines or streaks, especially a new dark brown or black vertical band (melanonychia), require immediate medical evaluation by a dermatologist. While it could be a benign mole or bruising from a physical injury, a dark streak can sometimes be an early indicator of subungual melanoma, a serious form of skin cancer.
How does nail psoriasis differ from a standard fungal nail infection?
While both conditions cause nail thickening and discoloration, they have distinctly different origins and traits. Fungal infections are contagious, external overgrowths that often destroy the nail edge first. Nail psoriasis is a non-contagious autoimmune condition characterized by distinct “pitting” (tiny dents on the nail surface), a yellowish discoloration resembling a drop of oil under the nail plate, and lifting of the nail from its bed, often coexisting with skin psoriasis plaques elsewhere on the body.
When should you consult a doctor or dermatologist for a nail condition?
You should consult a healthcare provider or a dermatologist if your nail abnormality persists, worsens, or causes ongoing pain and physical discomfort. Immediate professional evaluation is essential if you observe spreading redness, pus discharge, severe swelling, a complete separation of the nail from the skin bed, or unexplained color changes like dark black or brown streaks that do not grow out over time.
