Common Nail Conditions Flashcards
What is Onychocryptosis
Ingrowing nail, when nail edge enters the dermal layer of the skin
What are symptoms of Onychocryptosis?
red, shiny, painful, can be inflamed, pus under the sulus epidermis or the nail plate
How is Onychocryptosis caused?
Cutting nails too short, cutting nails at an angle, picking or tearing bits off the nail, Hyperhidrosis, ill-fitting shoes
What is Hyperhidrosis?
Excessive sweating
What happens in Onychocryptosis ?
as the nail grows into the tissue it stops normal healing causing Hypergranulation ( excessive tissue) which overlaps the nail plate
What are the stages of Onychocryptosis?
1- minimal injury to the sulcus ( where the nail meets the skin), slight swelling, discomfort, redness
2- Painful, excessive sweating , offensive odour, granulation tissue with pus
3- Epidermal overgrowth/ granulation tissue
What is the treatment for Onychocryptosis?
Removal of the nail spicule (spike) with nail nippers, edge of nail is filed down, apply sterile dressing. Alternatively full removal of partial nail or full using local anaesthetic
What does nail avulsion mean?
Nail removal
What is Onycholysis?
When the nail plate becomes detatched from the nail bed.
What does Onycholysis look like ?
White due to air getting under the nail plate, can be yellow/brown if onychomycosis present
What are the symptoms of Onycholysis?
No symptoms, not usually any pain, but debris can build up between nail plate and bed and cause discomfort and or infection
What causes Onycholysis?
Onychomycosis, trauma, psoriasis
How is Onycholysis treated?
Remove detached part of the nail to stop it catching or pulling, treat any jungle infection - refer to GP if systemic treatment needed
What is the prognosis of Onycholysis?
Good 3-6 months for nail plate to recover
What is Subungual
Haematoma?
Collection of blood beneath the nail plate caused by trauma, initially red then goes blue/black
What are the symptoms of Subungual Haematoma?
Swelling around the site which was injured pain due to the build up of blood under the plate
What causes Subungual Haematoma?
Trauma, systemic diseases eg haemophilia
What happens in Subungual Haematoma ?
rupture of the nail vessels for major trauma whole nail plate can be lost
How do you treat Subungual Haematoma?
In first 24 hours can drill distal edge to relieve pressure of blood and pain
Ice pack to reduce inflammation
What is the prognosis of Subungual Haematoma?
Good , if caused by trauma can take up to 12 months for it to grow through
What is Involution?
Increased transverse curvature of the nail plate
What are the symptoms of Involution?
Can have no symptoms, but can be painful if the nail that’s turning is pressing on the skin or has pierced it
What causes Involution?
trauma, ill-fitting footwear, poor nail cutting, bunion, malnutrition
What can happen in a diagnosis of Involution ?
Leads to alterations in the cell division between layers in the nail plate causing distortion of nail plate growth
How can Involution be treated?
Cutting part of the nail turning into the skin back to relieve pressure smooth any rough edges, may need partial or full nail removal for longterm - wear correct footwear, good hygiene
What is Melonychia?
Brown or black discoloration of the nail caused by haem or melanin
What causes Melonychia?
Trauma Onychomycosis,
Malignant melanoma (cancer), bacteria infections, Tumours mostly found in the big toe
What is subungual melanoma?
Serious type of skin cancer that occurs in the skin under the nail plate
What is Hippocratic or Clubbing?
Broadened digital tips Lovibonds angle >180 degrees
What causes Hippocratic?
Lung disease
* Cardiac disease
* Intestinal disease and excessive thyroid hormone
What occurs in clubbing?
nail emerges rom the proximal nail fold pointing upwards
What is Schamroth’s window?
The gap when two healthy finger nails are put together, creates a triangle shape where the distal part of the nails meet and the proximal part does not. in Clubbing the fingers meet at the proximal part and do not come back together at the distal part
What is Koilonychia?
Also known as spooning, Decompression of the nail which causes a spoon shape.
What causes Koilonychia?
Trauma, can be linked to nail patella syndrome, sign of iron deficiency, exposure to solvants
What is Onychorrhexis?
Exaggeration of the normal longitudinal ridges and
brittleness caused by protein layers of the nail separating linked to Associated with
* Lichen planus
* Rheumatoid A.
* Peripheral
circulatory
diseases
What are Beau’s lines?
Lines, grooves, furrows or ridges, going across the nail from left to right
What are Beau’s lines caused by?
Temporary interruption of matrix from trauma, or stroke or skin infection ushc as paronychia
What is Onychomadesis?
Separation of the nail plate from the proximal nail bed caused by metric scarring. Reasons it happens are trauma, Subungal Haematoma , Raynaud’s , infection
What does Onychauxis look like?
Brown/yellow discolouration of the nail, can have partial detachment from the nail bed- can be uncomfortable and can catch on socks, tights.hard to cut
What are the causes of Onychauxis?
Fungal infection of the nail bed, vascular issues, trauma, neglect /poor cutting, skin conditions
What is the pathology for Onychauxis?
The nail-late is completely disorganised, changes in the nail fold
How is Onychauxis treated?
reduction of the nail using clippers or drill, remove any debris from sulk and nail surgery if appropriate
What is Onychogryphosis?
Gross deformity with curvature into the shape of a ram’s horn
How is Onychogryphosis caused ?
Trauma, fungal infection of nail plate , eczema, psoriasis
