Nail Disorders and Nail Disease

Good, healthy nails are objects of admiration. They also protects the terminals of the limbs and the delicate tissues contained at these sites. The whole of the nail grows in about 5 months; in month the growth is about 1/8 of an inch.

The study of a nail includes: examination of a shape, contour, color, glossiness, translucency, consistency, deformity and structure. the later should include a study of the nail folds (both the posterior and lateral), the nail bed, the plate consisting of the root, the lunula and the body proper.

The common cause of nail disorders are:

The common cause of nail disorders are:

1. Congenital - Anonychia, pachyonychia, koilonychia. They occur as such, or in association with other congenital ectodermal defects.
2. Systemic diseases - Beau's lines, shedding of the nails, brittle nails, leuconychia, koilonychia, pigmentation, atrophy, debiliating disease or acute psychogenic stress may produce these lesions. Subacute bacterial endocarditis and trichinosis produce subungual haemorrhages. In acromegaly and gigantism, teh nails are hypertrophied, while in anaemia, myxodema and hypoparathyroidism, the nails are dry, brittle, thin and lustreless. Dystrophy of the nails may be seen in chronic arthritis; pulmonary tuberculosis produces Beau's lines, leuconychia and clubbing.
3. Skin diseases - The common ones are psoriasis, eczemas, leprosy, syphilis, tinea, erythroderma, alopecia areata and paronychia. They usually produce dystrophy of the nails.
4. Occupation - Soft or spoon-shaped nails in chemical workers particularly, when there is constant immersion in alkalies. Pigmentation may also be seen.
5. Trauma - Both physical and chemical. Subungual haematoma, ingrowing nails, claws nails, pterygium and so forth, are produced by physical trauma. Immersion of nails in alkalies may cause softening, even koilonychia. Ill fitting shoes and manucuring are responsible for many a disorder.
6. Vascular and neurogenic disorders - These interfere with the nutrition and growth of the nails; hence, dystrophic changes, eg., leprosy, syringomyelia, tabes, Raynaud's disease, etc.
7. Infections - Tinea, monilial, pyogenic and syphilis.
8. Nutritional - In malnutrition and avitaminosis, the nails become thin and brittle, and may also be shed.
9. Psychogenic - Nail biting, pitting, koilonychia and shedding of nails may be seen in acute psychogenic stresses. In the latter, it may accompany alopecia areata totalis.
10. Drugs - Usually produce pigmentary changes, viz., silver, arsenic, mepacrine, phenolphthalein, tetracycline etc.
11. New Growths - Sub-ungual and peri-ungual warts, fibromas, melanoma and glomus tumor.

Various terms and diseases of nails

• Nail pitting can be caused by psoriasis, alopecia areata and atopic eczema. A few pits can be present because of trauma.
• Onycholysis
• Koilonychia
• Leuconychia
• Beau's lines
• Yellow-nail syndrome
• Onychogryphosis
• Nail-patella syndrome
• Melanonychia
• Clubbing
• Ingrown Toenail
• Toe Nail Fungus
• Nail Fungus

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