Nail Disorders

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Nail disorders and diseases are distinct from diseases of the skin. Although nails are a skin appendage, they have their own signs and symptoms which may relate to other medical conditions. Deformity or disease of the nails may be referred to as onychosis.

Changes in the nails could be a sign of a local disease (like a fungus infection) or a systemic one like anaemia.

There are dozens of nail diseases and disorders, and a multitude of corresponding treatments. Nail disorders range from simple inflammation, to ingrown nails, nail loosening and seperation, fungal and/or bacterial infections, psoriatic nails, simmple nail trauma, even tumors in the nail matrix.

Nail inspection can give hints to the internal condition of the body as well. Nail disease can be very subtle and should be evaluated by a dermatologist with a focus in this particular area of medicine.

Nail Disorder Diagnosis

Pliability

  • Brittleness is associated with iron deficiency, thyroid problems, and impaired kidney function.
  • Splitting and fraying are associated with psoriasis and deficiencies of folic acid, protein and Vitamin C.
  • Unusual thickness is associated with circulation problems.

Shape and texture

  • Nail clubbing - nails that curve down around the fingertips with nailbeds that bulge is associated with oxygen deprivation and lung, heart, or liver disease.
  • Koilonychia - spooning, or nails that grow upwards. Associated with iron-deficiency anaemia or B12 deficiency.
  • Pitting of the nails is associated with Psoriasis.
  • Beau's lines are horizontal ridges in the nail.

Discoloration of entire nail bed

  • Yellowing of the nail bed is associated with chronic bronchitis, lymphatic problems, diabetes, and liver disorders.
  • Brown or copper nail beds are associated with arsenic or copper poisoning, and local fungal infection.
  • Redness is associated with heart conditions.

Other color changes and markings

  • Melanonychia (longitudinal streaking that darkens or does not grow out), especially on the thumb or big toe, may indicate subungual melanoma.
  • White lines across the nail (leukonychia striata, or transverse leukonychia) may be Mees' lines or Muehrcke's lines.
  • Small white patches are known as leukonychia punctata.
  • Dark nails are associated with B12 deficiency.
  • Stains of the nail plate (not the nail bed) are associated with smoking, and henna use.

Treatment

In approximately half of suspected nail fungus cases there is actually no fungal infection, but only some nail dystrophy. Before beginning oral antifungal therapy the health care provider should confirm a fungal infection. It is important to see a dermatologist to obtain the correct diagnosis and treatment, and avoid unneccesary health care and needless exposure to side effects.

Nail conditions that show signs of infection or inflammation require medical assistance.

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