HOW SHOULD DOCTOR EXAMINE THE NAILS
Abnormalities and disorder are common in the nail. Nail abnormalities are problems with the color, shape, thickness, and texture of the fingernails and toenails. About half of nail abnormalities result from fungal infection. The remaining half result from trauma and other serious health condition including cancer. Careful examination of the fingernails and toenails can provide clues about your health.
NAIL MATRIX ABNORMALITIES`
- BEAU LINES – are deep lines that run the length of a nail. They go from left to right across the nail and are due to a temporary disturbance of nail growth. They may occur as a result of severe illness, trauma or infection.
- PITTED NAILS – small depression or dent on the nail plate. Pitting is commonly associated with psoriasis, eczema, alopecia areata, or reactive arthritis
NAIL AND NAIL-BED ABNORMALITIES
- ONYCHOLYSIS – the nails are loose and are no longer completely attached to the nail beds creating a space under the nail that accumulates dirt. This is associated with injury or infections, reaction to drugs and products such as nail hardeners, or in other cases thyroid disease and psoriasis.
- PARONYCHIA – inflammation of the nail fold (tissue that frames and supports the nail), the area may appear red, swollen and often tender. If it lasts longer than six weeks it is termed chronic paronychia
- SPLINTER HAEMORRHAGE – lines of blood lying parallel to the long axis of the fingernails or toenails caused by tiny damaged blood vessels. They usually appear as little red or brown streaks underneath the nails. Splinters under one nail are usually of little concern but if they affect many nails, they may be a sign of lupus erythematosus, psoriasis, or endocarditis.
- DESTROYED NAIL – a nail destruction may result from skin conditions such as psoriasis, lichen planus, wart, or injury.
- NAIL-PATELLA SYNDROME – a rare genetic condition that may cause missing nails, usually at birth.
THE NAIL IN SYSTEMATIC DISEASE
- KOILONYCHIA – nails that curve inward like a spoon and appear soft or thin may be as a result of iron-deficiency anemia, lupus erythematosus, heart disease, or a liver condition known as hemochromatosis.
- HALF WHITE, HALF BROWN NAILS – Fingernails that appear like this can be a sign of kidney failure.
- TERRY’S NAILS – nails that appear white with reddened tips. It can be a sign of a wide range of medical conditions such as liver cirrhosis, diabetes, overactive thyroid, or even malnutrition.
- MELANOMA- nails that have new or changing dark streak may result from melanoma, the most common skin cancer
- COLOR CHANGE – the presence of disease inside your body can cause your nails to change color. Certain color changes can be a warning sign of a specific disease
Blue nails may indicate lack of oxygen in your bloodstream
Yellow nails may be a sign of lung disease or nail infection
Blue half-moon nails may indicate poisoning
Green nails may be caused by pseudomonal infection
Black nails may be due to vitamin B-12 deficiency
Grey nails can be caused by medications such as antimalarial or minocycline
CLUBBING
Clubbing occurs when the tips of the fingers enlarge and the nails curve around the fingertips, usually over time. In nail clubbing, fingertips swells and nails feel spongy when pressed. Clubbing could be a sign of various lung diseases such as lung cancer, pus in the lungs, pulmonary fibrosis, as well as heart conditions including endocarditis, or pericarditis. It is also associated with inflammatory bowel disease, AIDS, and liver disease.
Just like the skin, the nail tells a lot about your health.