Nail Changes

Nail Changes

Overview of Nail Diseases

Your toenails and fingernails protect the tissues of your toes and fingers. They are made up of layers of a hardened protein called keratin, which is also in your hair and skin. The health of your nails can be a clue to your overall health. Healthy nails are usually smooth and consistent in color. Specific types of nail discoloration and changes in growth rate can be signs of lung, heart, kidney, and liver diseases, as well as diabetes and anemia. White spots and vertical ridges are harmless.

Nail problems that sometimes require treatment include:

  • Bacterial and fungal infections
  • Ingrown nails
  • Tumors
  • Warts

 

Nail abnormalities

Nail abnormalities are problems with the color, shape, texture, or thickness of the fingernails or toenails.  If you notice any of the following changes to a fingernail or toenail, Dr. Rami Abadi will investigate your case.

What do fingernails tell about your health?

Like the skin, the fingernails tell a lot about your health:

  • Beau lines are depressions across the fingernail. These lines can occur after illness, injury to the nail, eczema around the nail, during chemotherapy for cancer, or when you do not get enough nutrition.
  • Brittle nails are often a normal result of aging. They can also be due to certain diseases and conditions.
  • Koilonychia is an abnormal shape of the fingernail. The nail has raised ridges and is thin and curved inward. This disorder is associated with iron defeciciency anemia. 
  • Leukonychia is white streaks or spots on the nails often due to drugs or disease.
  • Pitting is the presence of small depressions on the nail surface. Sometimes the nail is also crumbling. The nail can become loose and sometimes falls off. Pitting is associated with psoriasis and alopecia areata.
  • Ridges are tiny, raised lines that develop across or up and down the nail.

 What are the causes?

Injury:

  • Crushing the base of the nail or the nail bed may cause a permanent deformity.
  • Chronic picking or rubbing of the skin behind the nail can cause median nail dystrophy, which gives a lengthwise split or ridged appearance of the thumbnails.
  • Long-term exposure to moisture or nail polish can cause nails to peel and become brittle.

Infection:

  • Fungus or yeast cause changes in the color, texture, and shape of the nails.
  • Bacterial infection may cause a change in nail color or painful areas of infection under the nail or in the surrounding skin. Severe infections may cause nail loss. Paronychia is an infection around the nailfold and cuticle.
  • Viral warts may cause a change in the shape of the nail or ingrown skin under the nail.
  • Certain infections may cause red streaks in the nail bed.

Diseases:

  • Disorders that affect the amount of oxygen in the blood (such as heart problems and lung diseases including cancer or infection) may cause clubbing. 
  • Kidney disease can cause a build-up of nitrogen waste products in the blood, which can damage nails.
  • Liver disease can damage nails.
  • Thyroid diseases such as hyperthyroidsim or hypothyroidism may cause brittle nails or splitting of the nail bed from the nail plate (onycholysis).
  • Severe illness or surgery may cause horizontal depressions in the nails Beau lines.
  • Psoriasis may cause pitting, splitting of the nail plate from the nail bed, and chronic (long-term) destruction of the nail plate (nail dystrophy).
  • Other conditions that can affect the appearance of the nails include systemic amyloidosis, malnutrition, vitamin deficiency, and licehn planus. 
  • Skin cancers near the nail and fingertip can distort the nail. Subungal melanoma is a potentially deadly cancer that will normally appear as a dark streak down the length of the nail.
  • Hutchinson sign is a darkening of the cuticle associated with a pigmented streak and may be a sign of an aggressive melanoma.

Poisons:

  • Arsenic poisoning may cause white lines and horizontal ridges.
  • Silver intake can cause a blue nail.

Medicines:

  • Certain antibiotics can cause lifting of the nail from the nail bed.
  • Chemotherapy medicines can affect nail growth.

Normal aging affects the growth and development of the nails.