Nail Problems

“Did you know that nails can reveal clues to your overall health?”

1) Ridging of the nail:

Can be either along (longitudinal) or across (transverse) plane of the nail.
Longitudinal ridging causes:

• A. Prominent with increasing age
• B. Rheumatoid arthritis
• C. Lichen planus
• D. Injury to the nail.
• E. Transverse ridging causes:
  • a) Longstanding or severe eczema around the nail fold
  • b) Trauma

2) Thickening of the nail:

Seen frequently in the toenails of the elderly.
Causes:-

• A. Long term use of ill-fitting footwear /neglect of the nails.
• B. Psoriasis
• C.Fungal infection

3) In growing Toenail:

Often presents with pain, but may progress to infection results in difficulty while walking.
Causes :-

• A. Improperly trimmed nails
• B. Hyperhidrosis
• C. Poorly fitting shoes.

4) Leukonychia (white nail):

• A. Congenital
• B. Minor trauma
• C. Hypoalbuminaemia in chronic liver disease
• D. Renal failure
• E. Fungal infection.

5) Onycholysis:

Nail becomes detached from its bed at base and side
Causes:-

• A. Psoriasis
• B. Idiopathic or inherited
• C. Systemic disease, e.g. thyrotoxicosis
• D. Skin disease e.g. psoriasis
• E. Local causes e.g. trauma or chemicals.

6) Fungal Nail Infections:

Also called as onychomycosis (OM)/tineaunguium
Causes:-

• A. Fungal nail infections are most often seen in adults.
• B. Often follow fungal infection of the feet.
• C. More often in toenails than in fingernails.

You are at higher risk of getting a fungal nail infection if you:

• A. Get manicures or pedicures with tools that have been used on other people
• B. Have minor skin or nail injuries
• C. Have deformed nail or nail disease
• D. Have moist skin for a long time
• E. Have immune system problems
• F. Wear closed footwear

7) Symptoms:

A. Brittleness

B. Change in nail shape

C. Crumbling of the outside edges of the nail

D. Debris trapped under the nail

E. Loosening or lifting up of the nail

F. Loss of luster and shine

G. Thickening of the nail

H. White or yellow streaks on the side of the nail

8 ) Beau’s lines:

Depressions across the fingernail.
seen in:Illness
Injury to the nail
Malnourished.

9) Brittle nails:

• A. Aging.
• B. Certain diseases and conditions.

10) Koilonychia :

• A. Also called as spoon-shaped nails.
• B. Nail has raised ridges and is thin and curved inward.
• C. Associated with iron deficiency anaemia.

11) Pitting of nail plate:

• A. Small depressions on the nail surface
• B. Eczema
• C. Psoriasis
• D. Alopecia areata

12) Nail in Psoriasis:

Abnormalities include nail pitting

• A. Transverse furrows
• B. Crumbling nail plate
• C. Roughened nails
• D. Nail bed shows ‘oil spot’, distal onycholysis, distal subungual hyperkeratosis
• E. Splinter haemorrhages and false nail following spontaneous separation of nail plate.

13) Nail in Lichen planus :

• A. Thinning, brittleness, crumbling of the nail with accentuated surface longitudinal ridging.
• B. Colour change to black or white.
• C. Chronic inflammation causes either partial or complete loss of nail plate and formation of pterygium with partial loss of central nail plate seen as distal notch or completely split nail.
• D. Involvement of nail bed causes onycholysis, distal subungual hyperkeratosis, formation of bulla or permanent loss of nail.