NAIL DISORDERS Structure of Nail Common Nail Disorders

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NAIL DISORDERS Structure of Nail Common nail Disorders Affecting nail plate Psoriasis lichen planus Eczema Onychomycosis Affecting nail bed Warts Glomus tumor Melanocytic tumor Affecting nail fold Paronychia Psoriasis ‐ Pitting ‐ Grooves ‐ Erythema (nail bed) Psoriasis ‐Ridging ‐Longitudinal grooves ‐Discoloration Psoriasis Onycholysis (separation of nail from nail bed) Other causes include‐ trauma hereditary drug induced Psoriasis ‐Subungual hyperkeratosis (deposition of debris, ‐ dead keratin beneath nail plate) ‐ Lichen planus Discoloration Thinning Ridging Dystrophy Eczema Nail dystrophy Onychomycosis Infection of nail & nail folds by dermatophytes & nondermatophytic moulds T.unguium‐ onychomycosis by dermatophytes Disorders affecting nail bed Warts Disorders affecting nail bed Glomus Tumour Disorders affecting nail bed Melanocytic tumour Disorders affecting nail folds (Paronychia) Acute Paronychia‐ Severe pain, erythema, edema Bacterial‐ Staphylococcus Streptococcus Pseudomonas Chronic Paronychia ‐Inflammation due to irritant material beneath nail fold ‐Common in females with wet hands, Manicuring, Candida ‐Swelling of nail folds & base ‐Irregular transverse ridges Nail involvement in systemic diseases Leukonychia‐white nails Causes‐ cirrhosis, hypoalbuminemia hereditary chemotherapy Periungual fibroma (koenen’s tumour) Fleshy,smooth outgrowth arising from nail fold seen in Tuberous sclerosis Splinter haemorrhages brown black streaks seen underneath nail plate Causes‐ Trauma Psoriasis,atopic dermatitis vasculitis systemic infections Periungual erythema Collagen vascular diseases dermatomyositis Beau’s Lines transeverse band like depressions on nail plate seen in sudden febrile episodes Koilonychia (spoon shaped ) reversed curvature seen in ‐ anemia ‐ occupational Clubbing overcurvature of nail plate.

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Letters to the Editor IIdiopathicdiopathic aacquiredcquired truetrue Abnormal keratinization of nail plate is a possible explanation for true leukonychia. In past, biopsy of a lleukonychia:eukonychia: A fewfew ccommentsomments toenail, having trauma-induced acquired leukonychia, revealed an abnormal parakeratotic strip in the lower 1/3rd of nail plate. Leukonychia occurs due to reflection Sir, of light by these parakeratotic cells and loss of nail plate Leukonychia is the most common dyschromia of transparency.[4] While hereditary true leukonychia nails. We would like to add on the information is persistent and resistant to treatment, it requires [1] to an interesting case reported by Arsiwala in genetic counselling to unearth other syndromes in a your journal. In most of such nail aberrations, family. Removal or treatment of a cause in acquired it is difficult to make complete diagnosis. True leukonychia may result in complete reversal of this hereditary leukonychia may be another diagnostic nail abnormality. possibility here. Variable expression and incomplete penetrance in total hereditary leukonychia have Since leukonychia is rarely associated with other been documented in past.[2] Leukonychia partialis is systemic findings, one can speculate that there will a subtle variant or phase of leukonychia totalis with be many more cases compared to anecdotal reports variable expression of same genetic defect.[2] Absence published sporadically. It is imperative to diagnose this of family history does not necessitate diagnosis rare and intriguing nail abnormality correctly because of acquired leukonychia. There have been reports leukonychia cause extensive cosmetic embarrassment documenting onset of hereditary leukonychia in to the patient. childhood, not necessarily at birth.[3] Moreover, it is highly unlikely that trauma may result in total AACKNOWLEDGMENTCKNOWLEDGMENT leukonychia in all finger nails simultaneously.
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