Anail disease oronychosis is a disease or deformity of thenail. Although the nail is a structure produced by the skin and is askin appendage, nail diseases have a distinct classification as they have their own signs and symptoms which may relate to other medical conditions. Some nail conditions that show signs ofinfection orinflammation may require medical assistance.
Anatomy of the basic parts of a humannail. A. Nail plate; B. lunula; C. root; D. sinus; E. matrix; F.nail bed; G.eponychium; H. free margin.
Onychia is aninflammation of the nail folds (surrounding tissue of the nail plate) of the nail with formation ofpus and shedding of the nail. Onychia results from the introduction of microscopicpathogens through small wounds.
Onychocryptosis, commonly known as "ingrown nails" (unguis incarnatus), can affect either the fingers or the toes. In this condition, the nail cuts into one or both sides of thenail bed, resulting ininflammation and possiblyinfection. The relative rarity of this condition in the fingers suggests thatpressure from the ground or shoe against the toe is a prime factor. The movements involved inwalking or other physical disturbances can contribute to the problem. Mildonychocryptosis, particularly in the absence of infection, can be treated by trimming and rounding the nail. More advanced cases, which usually includeinfection, are treated bysurgically excising the ingrowing portion of the nail down to its bony origin and thermally or chemicallycauterizing the matrix, or 'root', to prevent recurrence. This surgery is calledmatrixectomy. The best results are achieved by cauterizing the matrix withphenol. TheVandenbos Procedure is a highly effective method that focuses on excision of excessive nail fold tissue without affecting the healthy nail and nail matrix. The Vandenbos Procedure is showing high success rates in eliminating onychocryptosis without altering the normal nail. Another, much less effective, treatment isexcision of the matrix, sometimes called a 'cold steel procedure'.
Onychogryposis, also called "ram's-horn nail", is a thickening and increase incurvature of the nail. It is usually the result of injury to the matrix. It may be partiallyhereditary and can also occur as a result of long-term neglect. It is most commonly seen in the greattoe but may be seen in other toes as well as the fingernails. An affected nail has many grooves and ridges, is brownish in color, and grows more quickly on one side than on the other. The thick curved nail is difficult to cut, and often remains untrimmed, exacerbating the problem.
Onychomadesis is the separation and falling off of a nail from thenail bed. Common causes include localizedinfection, minor injury to thematrix bed, or severesystemic illness. It is sometimes a side effect ofchemotherapy orx-ray treatments forcancer. A new nail plate will form once the cause of the disease is removed.
Koilonychia is when the nail curves upwards (becomes spoon-shaped) due to aniron deficiency. The normal process of change is: brittle nails, straight nails, spoon-shaped nails.
Subungual hematoma occurs when trauma to the nail results in a collection ofblood, orhematoma, under the nail. It may result from an acute injury or from repeated minortrauma such as running in undersized shoes. Acutesubungual hematomas are quite painful, and are usually treated by releasing theblood by creating a small hole in the nail.Drilling andthermal cautery are common methods for creating the hole. Thermal cautery is not used onacrylic nails because they areflammable.
Nail inspection can give hints to the internal condition of the body as well. Nail disease can be very subtle and should be evaluated by a dermatologist with a focus in this particular area of medicine. A nail technician may be the first to note a subtle change in nail health.[2][3][4]
Nail clubbing - nails that curve down around the fingertips with nailbeds that bulge is associated with oxygen deprivation and lung, heart, or liver disease.
In approximately half of suspected nail fungus cases there is actually no fungal infection, but only some nail dystrophy.[7] Before beginning oral antifungal therapy the health care provider should confirm a fungal infection.[7] Administration of treatment to persons without an infection isunnecessary health care and causes needless exposure to side effects.[7]
Roberts, D. T.; Taylor, W. D.; Boyle, J.; British Association of Dermatologists (2003). "Guidelines for treatment of onychomycosis".The British Journal of Dermatology.148 (3):402–410.doi:10.1046/j.1365-2133.2003.05242.x.PMID12653730.S2CID33750748.
Mehregan, D. R.; Gee, S. L. (1999). "The cost effectiveness of testing for onychomycosis versus empiric treatment of onychodystrophies with oral antifungal agents".Cutis.64 (6):407–410.PMID10626104.
