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admin | Category: What Cause Ed | 12.04.2014
Fingernail disorders are quite often a cosmetic problem, but sometimes a fingernail disorder may be important signs of a congenital or systemic disease. Anoxia at delivery, premature and birth trauma may cause nail dystrophy, abnormal color and shape.
Drugs administered to the mother during the first and second trimester of pregnancy are extremely significant factors for nail formation. Eczema, psoriasis, lichen planus, AA, epidermolysis bullosa, herpetic whitlow and onychomycosis are the most common diseases affecting nails in childhood.
There are at least 7 'normal' nail findings in newborns, infants and children, including: (1) Beau's lines, (2) fragile nails, (3) pits of the nail plate, (4) koilonychia, (5) v-ridging (chevron nails), (6) punctate leukonychia, and (7) periungual pigmentation. A total of 92% of normal infants between 8 and 9 weeks of age have a single transverse depression on the nail plate as a consequence of parturition. Onychoschizia is common in the first few years and is, at most, noted on thumbs and big toes. Small and shallow or large and deep, involving few or all 20 nails, pits of the mail plate may be caused by alterations in the proximal matrix.
Light brown to ochre pigmentation on the dorsal aspect of distal digit, has been reported recently in Caucasians infants between the age of 2-6 months and regress spontaneously before the age of 1 year.
Fingernails in early childhood often show superficial longitudinal oblique ridges, across the nail plate diagonally, from the matrix to the distal margin, forming a V-shaped pattern.
Also, in case of severe dermatitis, nail can acquire pits that may be either white or yellow in color. Different Types of Corrosion: Pitting Corrosion - Causes and Prevention, WebCorr Corrosion Consulting Services, Corrosion Short Courses and Corrosion Expert Witness. Visit your GP if your nails have changed in colour, texture, shape or thickness and you don't know why (you haven't injured your nails or been biting them).
Brittle nails are often just a sign of ageing or long-term exposure to water or chemicals such as detergents and nail polish.
A less common cause of crumbly nails is reactive arthritis, an unusual reaction of the immune system affecting the joints, muscles and other parts of the body following an infection. Green-black nails can be caused by overgrowth of bacteria called pseudomonas, especially under loose nails. Brown nails can sometimes be caused by thyroid disease, pregnancy, malnutrition and frequent use of nail varnish.
If the discolouration looks like a drop of oil under the nail plate or is the colour of salmon, you may have psoriasis of the nails. Fingernails that are half white and half brown (brown near the tips) can be a sign of kidney failure, where the kidneys stop working properly. Half-and-half nails have also been seen in some people with AIDS and can be seen following chemotherapy. If most of the nail plate has turned white and it's not because the nail has become detached from the nail bed, it's likely to be either a fungal nail infection or a sign of decreased blood supply to the nail bed, known as "Terry's nails". Sometimes, the big toenails become so overgrown and thickened that they resemble claws and are almost impossible to cut with conventional nail clippers. A loose nail should be cut back to where it's detached to allow the nail to become reattached as it grows.
Illness, injury or cold temperatures can interrupt nail growth and cause nail grooves to form at the base of the nails. These grooves tend to only be noticed a few months later, when the nails have grown and the grooves have moved up the nails to become visible. Clubbing of the fingertips means the tissue beneath the nails thickens and the fingertips become rounded and bulbous. White spots or streaks are normal and nothing to worry about, but parallel white lines that extend all the way across the nails, known as Muehrcke's lines, are a sign of low levels of protein in the blood. If you have dark skin, it's fairly common to find dark stripes running down your nails (linear melanonychia).
However, it's not something to ignore: dark stripes may sometimes be a form of skin cancer that affects the nail bed, called subungual melanoma.
Generally, subungual melanoma only affects one nail. Also, it will cause the stripe to change in appearance (for example, it may become wider or darker over time) and the pigmentation may also affect the surrounding skin (the nail fold).
If you have what look like red or brown little streaks underneath the nails, it's likely these are splinter haemorrhages – lines of blood caused by tiny damaged blood vessels. Just a few splinters under one nail are nothing to worry about and most likely due to injury of the nail.
If one of your nails becomes destroyed and you don't remember injuring it, it's important to see your GP. Paronychia is the name for inflammation of the nail fold, which is the skin and soft tissue that frames and supports the nail.


Paronychia can be acute, where it develops over a few hours, or chronic, where it lasts more than six weeks. Acute infective paronychia usually starts after a minor injury to the nail fold, such as from nail biting, picking or manicures. Acute paronychia is often caused by Staphylococcus aureus bacteria, although any number of germs can be involved. Sometimes, acute paronychia is caused by the cold sore virus, in which case it's known as herpetic whitlow.
Acute paronychia can completely clear in a few days with treatment, but if it's not treated or doesn't respond to treatment, it can become long-term (chronic).
To settle chronic paronychia, both the skin damage and the colonisation with germs needs to be addressed. It can take months for chronic paronychia to clear, and after that up to a year for nails to grow back to normal.
You may be referred to a dermatologist for further investigation of the underlying skin disease or for contact allergy testing, and for treatment advice. Pitting edema can be demonstrated by applying pressure to the swollen area by depressing the skin with a finger. In non-pitting edema, which usually affects the legs or arms, pressure that is applied to the skin does not result in a persistent indentation.
The focus of the rest of this article is on pitting edema, as it is by far the most common form of edema.
Edema is caused by either systemic diseases, that is, diseases that affect the various organ systems of the body, or by local conditions involving just the affected extremities.
The most common local conditions that cause edema are varicose veins and thrombophlebitis (inflammation of the veins) of the deep veins of the legs.
In some cases, however, edema may be a sign of a more serious underlying medical condition.
This disease causes scarring of your liver, which interferes with liver function, causing changes in the hormones and chemicals that regulate fluids in your body, as well as increasing pressure within the large blood vessel (portal vein) that carries blood from your intestine, spleen and pancreas into your liver. When you have kidney disease, your kidneys may not be able to eliminate enough fluid and sodium from your blood. Damage to the tiny blood vessels in your kidneys (glomeruli) that filter waste and excess water from your blood can result in nephrotic syndrome. Phenytoin provokes hypoplasia and longitudinal pigmented bands, warfarin causes hypoplasia and alcohol causes possible anonychia of the fifth digits.
Although nail dystrophies are quite often a cosmetic problem, sometimes may be important signs of congenital or systemic diseases. It is unclear why this change arises, but thumb sucking, nail biting and repeated trauma are thought to be the most common exacerbating factors. This condition is common in neonates and early childhood, usually on the great toenails, is caused by the fact that nails at this age are thin and soft, and it spontaneously resolves in a few years. When several such depressions emerge on a nail, it causes the surface to become rough and ugly. This kind of health problem, or rather a disease, causes the skin to become weak and causes silver scales on the skin.
They're often a sign of a fungal nail infection or injury, but can sometimes indicate a more serious underlying disease.
Nails can be strengthened by taking biotin (vitamin B7) supplements, by wearing gloves for all wet work and by frequently applying moisturising cream to the nails.
If you have a combination of symptoms affecting different parts of your body, your GP might consider this condition. This can be treated by applying antibiotic eye drops underneath the nails or soaking the affected nails in an antiseptic solution or vinegar. The link is not fully understood, but one theory is that kidney failure causes chemical changes in the blood that encourage melanin (a skin pigment) to be released into the nail bed. It's also possible that kidney failure causes an increase in the number of tiny blood vessels in the nail bed. This nail disorder is known as onychogryphosis ("ram's horn nails"), and is seen in older people or as a response to long-term pressure on the nails. However, if you haven't injured your nail, a loose nail is often caused by over-manicuring the nails and cleaning under the nails with a sharp object. It takes about four to six months for a fingernail to fully grow out, and 6-12 months for a toenail. This occurs in more than 77% of black people over the age of 20, and in most cases is perfectly normal.
However, if many nails are affected, these splinters may be a sign of lupus erythematosus, psoriasis, an infection of the heart valves (endocarditis) or another underlying disease. It's most common in people who often have their hands in water or chemicals, such as cleaners, bartenders, canteen staff or fishmongers.


The affected nail folds are swollen and may be red and sore from time to time, often after exposure to water. These germs thrive on previously damaged skin, without necessarily starting the skin damage in the first place. Edema most commonly occurs in the feet and legs, where it is referred to as peripheral edema. An accumulation of fluid in the interstitial air spaces (alveoli) in the lungs occurs in a disorder called pulmonary edema. If the pressing causes an indentation that persists for some time after the release of the pressure, the edema is referred to as pitting edema. Non-pitting edema can occur in certain disorders of the lymphatic system such as lymphedema, which is a disturbance of the lymphatic circulation that may occur after a mastectomy, lymph node surgery, or congenitally. The most common systemic diseases associated with edema involve the heart, liver, and kidneys. These conditions can cause inadequate pumping of the blood by the veins (venous insufficiency). This swelling (edema) is the result of excessive fluid in your tissues — often caused by congestive heart failure or blockage in a leg vein.
These problems can result in fluid accumulating in your legs and your abdominal cavity (ascites). One result of nephrotic syndrome is low levels of protein (albumin) in your blood, which can lead to fluid accumulation and edema. Chronic venous insufficiency (CVI) is a condition in which the veins in your legs are weakened or damaged and can't pump enough blood back to your heart. However, the nail plate of some infants is shorter than the distal nail pulp, resulting in a pseudo-ingrowing appearance, especially of the toenails.
Beau's line in all 20 nails presenting soon after birth appears to be associated with intrauterine distress.
Chevron nails remain of unclear significance and regress spontaneously in early adolescence. Before we move on to the causes of nail pitting, it is important to realize that there is a difference between pitting and nail peeling. After a while, when the disease is cured, the pitted nails will grow out, and new nails will replace the old ones.
Regular chiropody can help, but sometimes the nails need to be removed by a podiatrist or doctor. Sometimes, there's an underlying skin condition such as eczema or psoriasis or another medical condition such as diabetes or HIV.
The nail plate gradually becomes thickened and ridged as it grows, and may become yellow or green and brittle. The swelling is the result of the accumulation of excess fluid under the skin in the spaces within the tissues.
Any form of pressure, such as from the elastic in socks, can induce pitting with this type of edema.
Another cause of non-pitting edema of the legs is called pretibial myxedema, which is a swelling over the shin that occurs in some patients with hyperthyroidism. In these diseases, edema occurs primarily because of the body's retention of too much salt (sodium chloride). The resulting increased back-pressure in the veins forces fluid stay in the extremities (especially the ankles and feet). The nail apparatus can be affected by a wide spectrum of congenital, familial or acquired disorders.
Although koilonychia is a temporary physiological condition in infants, it may also result from several congenital and acquired causes, such as ectodermal dysplasias, trichothiodystrophia, LEOPARD (lentigines, EKG abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retardation of growth and deafness) syndrome, nail-patella syndrome, thyroid diseases, Plummer-Vinson syndrome, AA, psoriasis, lichen planus and Darier's disease, or may be idiopathic or traumatic. Hence, if any abnormality in the nails, especially pitting, is observed, it is wise to consult and doctor and have a body checkup. All tissues of the body are made up of cells and connective tissues that hold the cells together. Anasarca refers to the severe, widespread accumulation of fluid in the all of the tissues and cavities of the body at the same time.
Diuretic medications are generally not effective, although elevation of the legs periodically during the day and compressive devices may reduce the swelling.
In various diseases, excess fluid can accumulate in either one or both of these compartments.



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