Nails, one of the skin appendages, undertake many functions, from protecting fingertips from trauma to holding small objects. In addition, nail changes play a guiding role in the diagnosis of various dermatological and systemic diseases. Here are the disease findings related to changes in the nail…
Nail Findings in Systemic Diseases
Clubbing: Increase in the curvature of the nail and It occurs with thickening of the surrounding soft tissue. It is most commonly seen in chronic lung, heart, liver or thyroid diseases.
Spoon nail: The nail plate takes the shape of a spoon. It can be seen especially on the big toe nail in children. It can also be seen in fungal infection, diabetes, lupus, and thyroid diseases.
Beau's lines: They are transverse depressions that appear on the nail. It occurs in more than one nail or in all nails due to a disease severe enough to affect the growth of the nail. It can be caused by various infections, medications, and autoimmune diseases.
White bands on the nail: Can be seen in liver cirrhosis, chronic congestive heart failure, and adult-onset diabetes. The whiteness seen at the free edge of the nail may be a sign of cirrhosis, and the whiteness at the base of the nail may be a sign of chronic kidney disease.
Yellow nail syndrome: Fingernails and toenails may appear hard, curled, and yellow-green. . It has been described together with lymphedema and pleural effusion.
Melanonychia: It is characterized by longitudinal dark stripes. It can be seen in drugs, Addison's disease, AIDS, hypertriodia, folic acid deficiency, vitamin B12 deficiency, Cushing's syndrome.
Nail Infections
Nail fungus is dermatophyte, yeast, and although rare, It can be caused by mold fungi. Diabetes and weakened immune system can lead to fungal infections. In addition, fungal spores survive for a long time on items such as towels, swimsuits, slippers and sunbeds used during bathing and swimming. Swimming pools, showers, saunas, fitness centers and locker rooms are also risk factors.
Environmental Nail Disorders
Nail edge inflammation:It is the inflammation of the soft tissue around the nail. Generally, thorn ingrown nails, nail biting, thumb sucking, hangnail pulling, unhygienic or incorrect manicure applications are the most common factors.
Ingrown nail: It occurs as a result of the hard nail getting stuck in the soft tissue. It is generally a chronic condition. It is often seen on the big toe. It occurs due to reasons such as inappropriate shoes, wrong nail cutting, weight, pregnancy, irritation, genetic predisposition.
Nail in Dermatological Diseases
Psoriasis nail. :There may be pits on the nail surface, white spots/dots, yellow oil drop-like spots, thickening under the nail, and brittleness. Nail psoriasis can easily be confused with fungal infections.
Lichen planus: Thinning of the nail, volume reduction, nail loss, tissue growth from the base of the nail to the top of the nail in the form of a wing may be observed. Nail thickening is less common.
Twenty-nail dystrophy: It occurs in the form of nail coarsening. Nails are dull and thin. It has a sanded appearance. It may be accompanied by regional hair loss.
Drug-Induced Nail Anomalies
Many or all of the nails may be affected due to cancer drugs and blood thinners. It is characterized by streaks, separation of the nail from its bed, blue-black bands, and redness in the soft tissue around the nail.
Melanoma
It is usually seen after the age of 50 and most commonly on the thumb, brown-black. , is characterized by vertical bands. Colored bands extend into the soft tissue at the base and sides of the nail. The presence of atypical moles in the family should be questioned.
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