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Healthy vs. Diseased Nails
Introduction:
At the extremity of each
finger point, nails are present on the dorsal side. The chief role
of nails is to shield and it in addition assists in a good grasp
for gripping things. It comprises a hardwearing fairly supple
keratinous nail plate that begins from the nail matrix. The nail
bed is a tender tissue beneath the nail plate. The nail fold or
the cuticle divides the skin and the nail plate. Natural healthy
nails are pale pink in hue and they have a convex surface from one
side to the other. While in three months fingernails grow 1 cm,
toenails take 2 years to reach the same length.
Significance Of Nails In
Diagnosing Disease:
The hue, look, shape and
quality of nails provide some information regarding the overall
well being and cleanliness of an individual. All physicians to
gain some indications regarding the possible cause of diseases
routinely inspect nails. By simply glancing at nails it is
possible to discern an individual’s sense of hygiene. An irregular
nail may be present from birth or on account of some disorders.
The causative factors for nail changes may range from
straightforward explanations to serious ailments. Therefore, it is
imperative for a doctor to examine them to identify the cause of
the disease. Some atypical results with likely causes are
addressed here for broad awareness.
1. Hygiene:
It is very simple to
recognize an unhealthy nail. Dirt deposition beneath the nail
plate’s distal end can lead to a possibility of pathogen intake
while eating. In case nails are not properly trimmed, it could
lead to worm problems in kids. When worms creep in the anal
opening, kids will scratch, and this causes the worms’ ova to
lodge beneath the nails, which will be ingested while eating.
Conspicuous nails could also make skin disease problems worse by
regular itching. Sharp nails in little children cause small
injuries when they kick their feet or wave their hands.
2. Nail Color:
a. When anemic, nails turn
pale.
b. In Nephrotic syndrome
and unrelieved kidney failure, dense white discoloration (leuconychia)
is observed.
c. In hypoalbuminaemia
like in cirrhosis and renal disorders, whitening is also observed.
d. Drugs such as anti
malarial, sulpha group, antibiotics, and so on can lead to nail
discoloration.
e. A black discoloration
of the nails is brought about by fungal infection.
f. Nails turn green or
black in pseudomonas infection.
g. In vasculitis,
particularly in SLE & polyarteritis, infarction of the nail bed
happens.
h. Red spots are observed
in nails because of splinter hemorrhages in rheumatoid arthritis,
sub acute bacterial endo carditis, collagen vascular diseases,
trauma, etc.
i. A blunt wound causes
hemorrhage, leading to black/blue discoloration of nails.
j. Nails turn brown in
renal diseases and in reduced adrenal functioning.
k. In Wilson’s disease,
the nail takes on a bluish semicircular tinge.
l. Due to reduction in
blood flow, nails turn yellow. Nails also turn yellowish in
psoriasis and jaundice.
m. All the nails turn
yellow in color with pleural effusion in case of yellow nail
syndrome.
3. Nail Shape:
a. Clubbing:
In this case, tissues at the bottom of the nails become thick and
the incline between the skin and the nail base is destroyed. The
nail turns more convex, with the tip of the finger becoming
swollen and appearing similar to a drumstick tip. When the
condition worsens, the nail appears like the beak of a parrot.
Causes of Clubbing:
Acute chronic cyanosis
Congenital Wounds
Lung diseases such as
bronchiactesis, empyema, pulmonary tuberculosis, and carcinoma
of bronchus
Abdominal diseases
such as polyposis of colon, crohn's disease, liver cirrhosis,
ulcerative colitis and so on
Heart diseases such as
sub acute bacterial endocarditis, fallot's tetralogy, etc.
b. Koilonychia:
In this case the nails
turn concave, almost spoon-like. This condition is observed in
anemia caused by iron deficiency. The nails, in this condition,
turn fragile, soft and emaciated. The usual convex nails become
concave.
c. In raynaud's disease,
lengthwise ridging is observed.
d. In dermatomyositis,
cuticles become frayed.
e. An indication of
systemic sclerosis, SLE, and dermatomyositis is Nail fold
telangiectasia.
4. Structure &
Consistency:
a. When nails develop
fungal infection, they tend to be discolored, misshapen,
hypertrophy and atypically fragile.
b. In psoriasis, alopecia
aereata and severe eczema, there is thimble pitting of nails.
c. Paronychia refers to
cuticle or the nail fold inflammation.
d. Onycholysis refers to
the nail bed severance as observed in infection, psoriasis, and
after having tetracyclines.
e. The nail is destroyed
in cases of epidermolysis bullosa, lichen planus.
f. Nail patella syndrome
is a genetic disorder where the nail itself is not present.
g. Nails become easily
broken in gangrene and raynauds disease.
h. Nail fall is observed
in psoriasis, thyroid diseases, and fungal infection.
5. Growth:
When the blood flow is diminished, the
nail growth is affected. Moreover, in case of acute sickness,
growth of nails is impacted. Once the symptoms recede, the growth
commences once more leading to development of crosswise crinkles.
These lines are known as Beau's lines and facilitate detecting the
date when the illness started.
Original Article
Source:
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