The color of the nails helps to diagnose many diseases in a timely manner. Changes in the color of the nail plates. Change in nail color

13.05.2019

CHAPTER 65 DISEASES OF THE NAILS

1. What are the functions of nails?
1. Nails protect the terminal phalanges and fingerpads from injury.
2. They increase the ability to recognize objects, thereby expanding our capabilities.
3. They are indispensable for relieving itching.
4. And for many people, the idea of human beauty is unthinkable without them.

2. What is the interest of nails for doctors?
The special importance of nails is due to their accessibility for observation. Often, nail changes are the first sign of a systemic disease and help in establishing an accurate diagnosis of an existing skin pathology. A myriad of external and internal factors can cause nail lesions, including infection, trauma, medications, habits, and tics.

3. Are any systemic diseases characterized by specific nail changes?
In many diseases, characteristic changes in the nails are found, but they, as a rule, are not a sign of any one specific disease. Most of the changes are part of a symptom or response that is extremely important for diagnosis. Changes in nails with systemic diseases

CHANGING NAILS	LOCALIZATION	SYSTEMIC DISEASE
Hemorrhage at the base of the nail	Nail bed	Bacterial endocarditis
Meesov strips	Nail plate	Arsenic poisoning
Müerke lines	Nail bed	Nephrotic syndrome
Terry's Nails	Nail bed	Cirrhosis
Half and half nails	Nail bed	Chronic renal failure
Blue nail lune	Nail metrics	Wilson's disease
Red nail lune	Nail matrix	Rheumatoid arthritis
"Drumsticks"	Nail plate / matrix	Pulmonary diseases
Koilonychia (concave nail)	Nail plate / matrix	Iron deficiency

4. What are the Beau lines? How are they formed?
Bo lines are the most common, but the most nonspecific, nail changes that occur in systemic diseases. They are wedge-shaped, forward-directed depressions in the nail plate, differing in curvature and depth (see figure).
These lines occur when the growth of the nail is temporarily stopped or the formation of the nail plate is slowed down by a part of the nail growth zone. Any moderate or severe systemic disorder leaves behind a well-defined classic trace in the form of numerous Bo lines, while local exposure (trauma) leads to the appearance of only separate lines.
Bo lines, clearly delineating the nail, in case of systemic disease

5. What are the hemorrhages at the base of the nail?
Hemorrhages at the base of the nail are caused by the release of blood from the longitudinally located vessels of the nail bed. Blood usually adheres to the overlying nail plate and moves with it in the distal direction. The detection of blood near the nail lune and on several fingers at the same time is highly likely to indicate the presence of a systemic disease.

6. Is hemorrhage at the base of the nails always associated with the presence of subacute bacterial endocarditis?
If you say yes, you will be wrong, as are most doctors. While studying medicine, I have always kept this connection in mind. However, there are many reasons for this symptom, and subacute bacterial endocarditis is far from the most common of them. More often it is caused by trauma. Some other reasons include drug reactions, psoriasis, general diseases, vasculitis, trichinosis, etc.

7. What is the difference between Meesov stripes and Müerke lines?
Meesian stripes are single or multiple transverse white lines that appear in the nail plate and move distally as the nail grows. They are considered the hallmark of arsenic poisoning, but can also occur in connection with many severe systemic diseases. Müerke's lines were described in 1956 by Robert Müerke in the article "Fingernails in chronic hypoalbuminemia". They are double transverse white lines and indicate pathology from the side of the vessels of the nail bed, most likely local edema caused by a state of hypoalbuminemia. Diseases that can result in Bo lineages include nephrotic syndrome, liver disease, and malnutrition.

8. What are drumsticks?
"Drumsticks", or "drumsticks", are characterized by bilateral curvature of the nails and proliferation of soft tissues in the terminal phalanges. This leads to a change in the critical angle of the nail - it becomes more than 180 ° (normally less than 180 °). There are many factors, including congenital or hereditary, that cause the appearance of "drumsticks", but in 80% of cases it is due to pathology from the lungs.

9. What is the relationship between "drumsticks" and hypertrophic osteoarthropathy?
"Drum fingers" can be caused by hypertrophic osteoarthropathy, a rare but noteworthy disease that manifests itself, in addition to the "drum fingers" (including the toes), hypertrophy of the upper and lower extremities, peripheral neurovascular disorders, acute burning pain in the bones, pathology with side joints and muscle weakness. But, more importantly, the detailed picture of the disease in 90% of cases is characterized by the presence of malignant tumors of the chest cavity organs.

10. What is yellow nail syndrome?
Yellow nail syndrome consists of the classic triad of symptoms: lymphangiectatic edema of the lower extremities, nail changes, and pleural effusion. At the same time, the nails are thickened, painted in a yellowish color, curved from side to side, and the lune and cuticles are absent. The syndrome is observed in many lung diseases, including tuberculosis, asthma and malignant diseases of the respiratory tract.

11. What are the pits on the nails?
Shallow depressions on the surface of the nail plate are the result of abnormal preservation of nuclei in the cells that form the stratum corneum, which are usually lost as they grow.

Randomly located large depressions on the nail plate with psoriasis

12. Are there any characteristic nail changes in primary skin diseases?
Since the ability of the nail to respond to the occurrence of any pathology is limited, unfortunately, there are no specific pathognomonic changes in the nail inherent in only one disease. However, the study of nails seems to be very important, because typical changes, taking into account the general clinical picture, often help in making an accurate diagnosis. Skin diseases accompanied by changes in the nails

DISEASE	FREQUENCY	MANIFESTATIONS
Psoriasis Alopecia areata Lichen planus Scleroderma Darya's disease Pityriasis red hair	10-50% 10% 10% Often Very often Most	Depressions, "oil spots" Depressions Pterygium of the nail Pterygium of the nail inverted Wedge-shaped hyperkeratosis Yellowish-brown color with hyperkeratosis

13. Is there a difference between depressions on the nail in psoriasis and alopecia areata?
The depressions found in psoriasis are usually greater in size and depth and are arranged irregularly (see figure). With alopecia areata, they are smaller in diameter and depth, homogeneous and have a line pattern. However, sometimes it is not possible to differentiate between these two forms.

14. What other nail changes occur in psoriasis?
With psoriasis, all parts of the nail "complex" are sometimes affected and, therefore, a wide variety of changes are observed that can help in making a diagnosis. Below, in accordance with the frequency of detection, the forms of nail lesions in psoriasis are listed:
Depressions in the nail plate
"Oil stains" (brownish-yellowish color)
Onycholysis (detachment of the nail plate)
Subungual hyperkeratosis
Pathological changes in the nail plate
Hemorrhage at the base of the nails

15. What are the most common causes and consequences of subungual hemorrhage?
The main cause of a subungual hematoma is trauma to the nail bed. In most cases, subungual hematomas are accompanied by throbbing pain caused by the accumulation of blood under the nail plate and its pressure on the nail bed. A simple and effective method of treatment, available even for an inexperienced physician, is to puncture the nail plate at the site of the hematoma using the heated end of a paper clip. Reducing pressure leads to quick pain relief and instantly makes you a hero.

16. How is nail pterygium different from inverse nail pterygium?
Pterygium (from the Greek. "wing") in the classical form due to the presence of lichen planus. The disease affects the nail-forming part, the matrix, leading to the appearance of a persistent scar. Since the formation of the nail in this place stops, the proximal part of the nail fold directly fuses with the nail bed and further spreads in the distal direction.
The lesion resembles wings in appearance (see figure A). Inverse nail pterygium occurs when the nail plate in the distal part is not separated from the nail bed. Ulceration and scarring of the fingertips in scleroderma can also result in inability to separate the nail (see figure B).

A. Pterygium of the nail in a patient with lichen planus. C. Absence of a distal nail in a patient with scleroderma with the appearance of an inverse pterygium of the nail

17. Can malignant melanoma develop in the nail area?
Yes. Although subungual melanomas occur in only 1–4% of all melanomas in fair-skinned people, in people with black skin, the proportion is, however, 25%.

18. How to distinguish a subungual hematoma from malignant melanoma in the nail area?
It is imperative to be able to distinguish one lesion from another, as late diagnosis of melanoma increases the likelihood of death. Particular vigilance should be caused by the appearance of pigmentation in the area of one of the nails in a person 50-80 years old, as well as any stripes in the nail area, wider at the base, and darkening. Hutchinson's syndrome is considered pathognomonic - the spread of pigmentation to the surrounding nail fold. The darkened area with a hematoma is limited to the nail bed and, as the nail grows, is displaced distally.

19. What causes the change in nail color in AIDS patients?
People with AIDS can develop acromelanosis, in which hyperpigmented spots are found on the fingers, palms, soles, and nails. In the area of the nails, they appear in the form of longitudinal pigmented stripes (melanonychia). The most common cause of changes in nail pigmentation is the use of zidovudine during treatment.

20. What is onychocryptosis, and what are its causes?
The most common pathology of toenails is onychocryptosis, or ingrown toenail. Onychocryptosis develops when the nail plate invades the soft tissue of the nail fold. Factors contributing to its development or causing this condition include excessive unfolding of the toes, detachment of the nail plate along the edge, inappropriate shoes, hyperhidrosis, improper nail cutting (rounding of corners). Infection is already a complication of an ingrown but gtya.

21. What is paronychia?
Paronychia is an inflammation of the nail fold surrounding the nail plate. It can be acute or chronic. In adults, acute inflammation is more common, in children - chronic. The difference is due to the habit of sucking fingers in children, which creates favorable conditions for the development of bacteria and yeast. Sometimes paronychia occurs as a result of infection, injury, or persistent irritation.

22. What pathogens cause paronychia?
Acute lesions are usually caused by bacteria such as staphylococci, streptococci, and Escherichia coli. Chronic forms of paronychia are more often observed in the form of tuberculous, syphilitic, leprosy lesions, or various strains become their causative agents Candida.

23. How to treat the acute form of paronychia?
A quick and easy method to ease the suffering of the patient and speed up healing is to freeze the affected area (for pain relief) and puncture with a scalpel blade (No. 11) (to release pus). This provides the ability to remove purulent contents and use antibiotics (usually dicloxacillin), the action of which is directed against Staphylococcus aureus before the culture data is obtained.

24. What are the causes of green nails?
Most often, the defeat is caused by Pseudomonas aeruginosa, which can colonize the pathologically raised nail plate. This bacterium produces the pigment pyocyanin, which gives the nail a greenish tint. Treatment consists of topical application (after removing the nail) of antiseptics or antibiotics.

25. Despite adequate treatment, an epidemic of scabies is raging in your department. What can you suggest to combat it?
Since this issue is discussed in the chapter on nails, it is not hard to guess that the problem may lie in the nails. And although this is by no means a characteristic place, but under the nails, among organic residues, it is possible that itch itch may be found, which got there when combing. There are cases when it was the presence of itching that became the cause of persistent invasions or epidemics. Patients should be encouraged to cut their nails short during treatment and brush their fingertips with a brush smeared with an anti-scabies preparation.

26. What organisms usually cause onychomycosis?
Onychomycosis is a specific fungal infection of the nail. Most often, lesions are caused by:
Trichophyton rubrum(In most cases)
Trichophyton mentagrophytes
Epidermophyton floccosum

27. What viral infections most often affect the tissue around the nail?
Common periungual warts secondary to human papillomavirus infection. It is known how difficult periungual warts are to heal. Molluscum contagiosum can also infect tissues around the nail.

28. List the common benign "tumors" that develop in the tissues surrounding the nail.
Acquired fibrokeratoma of the fingers
Exostosis
Glomus tumor
Periungual fibroma
Pyogenic granuloma
Myxoid / mucous cyst

29. What is exostosis?
Exostosis is a benign bone growth commonly seen in the distal phalanges of the toes, and most commonly on the big toe. Initially, the bone is involved in the process, and then the nail. It is believed that trauma plays a role in its development. Most often, the disease develops in young women, It manifests itself in the form of a slowly growing painful formation located under the nail and often accompanied by a secondary infection (see figure). Plain X-rays will easily reveal the pathology.

Exostosis that lifts the nail plate and looks like a fleshy tumor

30. Name the 4 most common malignant tumors of the nail "complex".
Squamous cell carcinoma (including Bowen's disease) is the main malignant neoplasm that affects the tissues of the nail and the entire toe. It is followed in frequency by malignant melanoma, basal cell carcinoma and keratoacanthoma.

Vasilenko V.V., Vinogradov D.L.

Moscow Medical Academy. THEM. Sechenov, Russia

Drumstick symptom

Synonym: fingers of Hippocrates, digiti Hippocratici. With this symptom there is a softening of the nail bed with a violation of the normal angle between the nail bed and the skin fold, an increase in the bulge of the skin fold, thickening of the distal part of the finger so that the finger looks like a drumstick.

To determine the presence of this symptom, you can use the Chamroth sign. If, when two fingers are connected, a small space is visible between them, resembling a diamond crystal (Shamroth window), this means that the patient does not have the symptom of “drumsticks”.

The symptom of drumsticks in 5% of cases is observed in patients with pathology of the gastrointestinal tract - mainly with tumors (esophagus, liver, intestines).

Symptom "nails of Hippocrates"

Synonym: "watch glasses", ungues Hippocratici - an early stage of deformation of the fingers like drumsticks.

Koilonychia

Koilonychia - concave, spoon-shaped nails. It is normally present in children and usually disappears with age. To determine the presence of a symptom, a test is carried out with a drop of water. A drop of water is placed on the nail. If the drop does not fall, does not drain, then the nail is flattened, which is an early sign of the development of koilonychia.

Koilonychia can be a symptom:

lack of iron;
diabetes mellitus;
protein deficiency, especially reflects the lack of sulfur-containing amino acids (cysteine or methionine);
poisoning with gasoline and similar chemicals;
systemic lupus erythematosus;
Raynaud's disease.

Change in nail color

Leukonychia

The nails on the hands and / or feet become uniformly white and have a characteristic “matte” color; the nails have no border with the nail lune. The changes are explained by a decrease in vascularization and proliferation of connective tissue in the nail bed. Leukonychia of varying severity is found in 80% of people with chronic diffuse liver diseases. It is also observed with congestive heart failure, diabetes mellitus, thyrotoxicosis, alimentary dystrophy.

Terry's nails, or half nails

Terry, in 1954, was the first to describe this nail pathology in detail in a patient with liver cirrhosis. In 1984, Holzberg refined the criteria for the diagnosis of half nails. These criteria are currently being applied. Affected nails look like this. The proximal part of the nail is white (edema and anemia), while the distal part of the nail is dark. The nail bed is white or light pink, in the distal part there is a transverse strip 0.5 to 0.3 mm wide, pink or brown. Lunula (continuation of the root matrix, white lunar formation) may be absent.

Terry's nails can occur with physiological aging, as well as with pathology. This deviation is most typical for liver cirrhosis and congestive heart failure.

Yellow nail syndrome

A rare pathology characterized by nail changes, lymphatic edema, pleural effusion, and chronic respiratory tract infections. It is associated with autoimmune diseases, and may also appear due to long-term use of certain medications.

The syndrome is associated with the development of a number of malignant neoplasms, in particular, gallbladder carcinoma. Nails are yellow, thickened, slowly growing. Absence of cuticle, erythema and edema of the proximal nail fold are sometimes noted. Changes in the nails can be the first manifestation of the disease, the rest of the symptoms develop over several years. Nail changes disappear after successful tumor treatment.

Longitudinal brown line syndrome

Longitudinal brown lines appear as a result of increased production of melanin by melanocytes of the nail bed.

Could be related:

with Addison's disease;
the presence of a nevus on the nail bed;
breast cancer;
melanoma (check for periungual hyperpigmentation);
nail injury.

Bibliography

Schamroth L. Personal experience. S. // Afr. Med. J. - 1976 Feb. - 50 (9). - 297-300.
Jemec G.B., Kollerup G., Jensen L.B., Mogensen S. Nail abnormalities in nondermatologic patients: prevalence and possible role as diagnostic aids // J. Am. Acad. Dermatol. - 1995 .-- 32 .-- 977-81.
Terry R. White nails in hepatic cirrhosis // Lancet. - 1954 .-- 266 .-- 757-9.
Holzberg M., Walker H.K. Terry's nails: revised definition and new correlations // Lancet. - 1984. - 1. - 896-9.
Samman P.D., White W.F. The "yellow nail syndrome" // Br. J. Dermatol. - 1964 .-- 76 .-- 153-157.
Iqbal M., Rossoff L.J., Marzouk K.A. et al. Yellow nail syndrome: resolution of yellow nails after successful treatment of breast cancer // Chest. - 2000 .-- 117 .-- 1516-1518.
Gupta A.K., Davies G.M., Haberman H.F. Yellow nail syndrome // Cutis. - 1986 .-- 37 .-- 371-374.
Guin J.D., Elleman J.H. Yellow nail syndrome. Possible association with malignancy // Arch. Dermatol. - 1979. - 115. - 734-735.

Even the ancient healers of China and India were able to recognize diseases of the nails and judge human health by them. Modern dermatologists confirm that when pathological processes occur in the body, they most often affect the state of the nail plates. Diagnosis of diseases by nails is only preliminary. However, signs of ill health, noticed in time, help to immediately consult a dermatologist and not start the disease.

Changes in the color of the nail plates

They can become grayish after taking some drugs, such as Minocycline or Quinine. Nails often acquire a slightly brownish tint in pregnant women, with diseases of the thyroid gland, in patients who are severely exhausted by a long-term illness. If a reddish or pink speck or dot appears under the nail plate, this may be a symptom of developing psoriasis.

The nails acquire a dark green tint with pseudomonas onychia, a bacterial disease that is caused by Pseudomonas aeruginosa that settle in the plates. Yellowing of nails occurs not only with prolonged use of nail polishes, taking Mepacrine, preparations containing carotene, but also for many other reasons associated with ill health. Possible diseases include:

fungal infection;
psoriasis;
hepatitis;
sinusitis (inflammation in the paranasal sinuses);
lymphatic edema;
thyroiditis (inflammation of the thyroid gland);
bronchiectasis (severe lung disease);
tuberculosis.

It happens that a significant area of the nails whitens, but they firmly adhere to the bed. This pathology in medicine is called "Terry's nails" (photo 1). Its reasons are as follows:

fungal infection;
the normal blood flow has stopped flowing to the fingertips.

If white nails have dark or reddish tips, this may indicate the presence of the following conditions:

cirrhosis of the liver;
diabetes;
hyperthyroidism (overactive thyroid gland);
Iron-deficiency anemia.

Sometimes you can see "two-color" nails: half white, half red-brownish. Such an anomaly indicates a serious kidney disease. Scientists believe that this is the deposition of skin pigment melanin in the nail bed. In addition, it is likely that it is renal failure that stimulates the appearance of numerous capillaries under the nail plates, which are visible through them.

According to medical statistics, every fourth patient with severe kidney disease becomes "bicolor" nails. Sometimes this color occurs after chemotherapy courses, as well as in AIDS patients. Many types of pigmentation changes are signs of certain pathologies.

Delamination of plates

This phenomenon is not uncommon in the elderly. This is one of the inevitable consequences of natural aging of the whole organism. However, fragility of the plates is just as common in young women. It is caused by prolonged contact of hands with water, cleaning agents, nail varnishes. Their stratification can be stopped by taking preparations with vitamin B7. At the same time, it is important to protect your hands from the harmful effects of water, aggressive household chemicals, using gloves, protective creams.

In addition, fragile, brittle plates often become due to such pathologies:

onychomycosis is a fungal disease that especially strongly undermines the strength of the nails on both the hands and feet (photo 2);
psoriasis is a difficult to treat, in fact a lifelong skin pathology that causes scaly plaques on the skin, and can also cover the nails;
lichen planus - although this is also a skin disease, sometimes it affects only the nails;
hyper- or hypothyroidism - excessive or, conversely, insufficient activity of the thyroid gland in the production of hormones;
reactive arthritis is an inflammatory disease of the joints caused by an aggressive attack by the immune system of its own tissues (after an infectious disease, it gradually destroys the joints and muscles).

Deformation of the plates

A common pathology is their growth and thickening. The reasons for this phenomenon are:

constant squeezing of the feet for a long time with shoes;
fungal infection;
psoriasis;
reactive arthritis.

Sometimes in older people, the nails grow so large on the big toes that they become abnormally thick, like claws. Because of this, it is possible to trim them with great difficulty. This is how the nails often react to prolonged squeezing. Sometimes too thick "claws" even have to be removed.

Another variant of the deformation of the plates is “hollows” in their middle part. If at the same time the nails are clearly bent inward, resembling spoons, the causes of the anomaly may be:

Iron-deficiency anemia;
hemochromatosis (a disease characterized by an excess of iron compounds in the blood);
lupus erythematosus (a rare but very dangerous disease when the immune system perceives its own cells, tissues as foreign, foreign and seeks to destroy them);
Raynaud's disease is a very common pathology in which, due to a lack of blood flow, the fingers of the extremities become pale.

When, on the contrary, blood circulation in the fingertips increases, they thicken, and the nails become like rounded pieces of glass. This anomaly is called "drumsticks" and "watch glasses" (photo 3). The following reasons are likely:

severe pathologies of the lungs or heart (asthma, COPD, lung cancer, endocarditis, etc.);
inflammatory diseases of the digestive tract, stomach or intestinal cancer;
cirrhosis of the liver;
polycythemia (blood clotting).

In the presence of "pits" on the nails, the following diseases can be suspected:

psoriasis (almost half of people suffering from this ailment have such "pits");
eczema;
reactive arthritis;
alopecia areata (gradual baldness of typical areas of the head).

Due to strong subzero temperatures, injuries, long-term diseases, the nail can stop growing, and deep grooves often appear at its base. They are located across the plates from left to right and are called Bo furrows (photo 4). Such wavy deformities can also appear several months after chemotherapy courses in cancer patients. During this time, the plate grows back, and the grooves "rise" higher.

Stripes and falling off of records

It is normal for white dots to appear on your nails. Another thing is the white stripes located across the plates - the lines of Mürke (photo 5). They indicate that the protein content in the blood has dropped. Such a pathology occurs with hepatitis or with an unbalanced diet, which is characteristic of many diets for weight loss.

If the stripes are not white, but dark, then sometimes they appear with subungual melanoma - a cancer that occurs in the nail bed. As a rule, such an oncological pathology affects only one nail. It is worth paying attention to brownish or reddish strokes. If there are many of them, one can suspect the development of psoriasis, lupus erythematosus or endocarditis in a person.

Neglected nail diseases are fraught with their loss. When the plate falls off after a severe injury to the finger, this is quite understandable. But more often the plates move away from the bed due to numerous diseases. These include:

fungal infections;
psoriasis;
lichen planus;
hyperthyroidism;
amyloidosis (excess protein in the tissues);
circulatory disorders in the fingers;
warts around the nail;
allergic reactions to medications (most often to antibiotics or nail cosmetics).

Diseases of the nails are extremely diverse, and it is not so easy to understand them. In any case, at the slightest suspicion of a deviation from the norm, you should show your hands or feet to a dermatologist. A brief description of the most famous diseases will help you better navigate the unfamiliar names of diagnoses, which the attached table deciphers.

Common nail diseases

Diagnosis		Features of pathology
Pathologies of an infectious nature
Onychomycosis	Fungal infection resulting in loosening, thickening, bumpiness, or delamination of the plate. It is dangerous because it quickly passes from the patient to healthy nails. It is highly contagious.
Ringworm	A fungal disease that develops first along the edges, and then in the roots of the plates. The appearance of white spots, stripes is characteristic. When the bed is infected, the surface layers become thinner and lag behind, exposing the affected tissue zones.
Onychoptosis	A disease that develops as a result of trauma, high body temperature, and syphilis. The nail can collapse completely and fall off.
Paronychium	Inflammatory disease of the tissues around the fingertips that are infected with yeast or bacteria. Often this is the result of injuries, unsanitary conditions, exposure to corrosive substances.
Pathologies of a non-infectious nature
Onychophagia	Nail biting by children and adults is an uncontrollable craving due to neurogenic addiction. As a result, the plates are deformed, disfigured and often become infected.
Onychotillomania	An obsessive desire to mechanically destroy one's own nails. Pathology is typical for people with psychopathic disabilities, especially in states of excitement or depression.
Onychogryphosis	A disease in which the plates thicken, bend and become like claws. Pathology occurs as a result of injuries, fungal infections, congenital anomalies.
Onycholysis	Dystrophy of the nails, in which their connection with the bed is broken and the plates fall off the free edge. Pathology is classified depending on the reasons (traumatic, chemical, systemic onycholysis, etc.).
Onychomadesis	Rejection of the nail from the bed when it occurs from the base of the nail as a result of trauma, infection by candida fungi or streptostaphylococci, etc.
Onychoshisis	Transverse splitting of the free edge of the nail in the form of layering thin plates. It is often found among musicians playing string instruments, pianists.

The nails of a healthy person are smooth, shiny, pale pink in color, with a pronounced whitish hole at the base. At the same time, the nail plate is constantly renewed, growing by about one millimeter in a week.

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With age, the nail plate thickens and becomes more brittle. It is part of the body's natural aging process. Fragility is also characteristic of women's nails. But within six months after giving birth, everything usually returns to normal.

It is acceptable if the nails break due to a lack of vitamins or turn yellow due to poor-quality varnish. Sometimes the nail plate may even turn black and fall off if the finger is pinched or hit.

In a healthy person, the nails on the hands are completely restored within 4–6 months, and on the legs - within 6–8 months.

But there are persistent pathologies that we often do not even pay attention to. But in vain. Some changes in the shape, color and texture of nails, as well as the skin around them, may indicate disturbances in the functioning of internal organs and the presence of a variety of, sometimes serious diseases.

What are the deviations

yalmashop.ru

If a nail breaks just beyond the edge of a finger, it is likely that the body is deficient in A, E, and C, as well as iron and zinc. Sometimes fragility can be a consequence of thyroid disease and a harbinger of diabetes.

polzapost.ru

They are popularly considered a good omen, but in medicine this pathology is called leukonychia. Microscopic air bubbles form between the layers of the nail plate, which on the surface look like white dots and stripes.

Leukonychia is punctate (a couple of spots on several nails) and total (when the entire plate is affected). The reasons are varied: from injuries and unbalanced nutrition to exhaustion of the nervous system and heart failure.

dingyue.nosdn.127.net

In shape and color, the nails look as usual. But if you look closely, the nail plate is riddled with tiny indentations (as if pierced with a needle). Doctors even have such a term - thimble-like groove.

This is almost always a sign. Sometimes eczema or arthritis can manifest itself this way.

Having found this or any other pathology of the nail in yourself, you should not self-medicate. The first thing to do is make an appointment with a therapist and / or dermatologist, get tested. Only a professional doctor and clinical research are able to give an exact answer, what is the cause of the pathology. Maybe this is some stage of psoriasis, or maybe just a malfunction in the thyroid gland or gastrointestinal tract.

Olga Aleinikova, nurse, master of manicure and pedicure

ofigenno.com

Lunulae or holes are a light crescent moon at the base of the nail. They should occupy about a third of it and be clearly visible.

Holes that are too large are used by athletes and people doing hard physical labor. Sometimes they can indicate malfunctions and blood vessels, low blood pressure.

Small lunulae, barely peeking out from under the cuticle, can be a sign of a lack of vitamin B12 and iron, as well as circulatory problems.

dermline.ru

These are the so-called Bo lines. The pathology of the nail plate in the form of transverse lines up to one millimeter deep was first revealed by the French military surgeon Joseph Honore Simon Bo.

Bo lines are formed due to damage to the matrix of the nail plate. When she lacks nutrition, the chemical composition of the nail changes and its plate deforms. Most often this happens due to strict diets bordering on fasting.

Also, these injuries can be mechanical (when the nail is struck in the area of the hole) or toxic in nature (due to potent drugs or chemotherapy). Sometimes Bo lines can appear against the background of cardiovascular diseases, fungal and other infections.

womens-blog.ru

If for the elderly such a change in the relief of the nails can be considered the norm, then for people under 50, protruding vertical stripes most likely indicate a lack of B vitamins and trace elements (zinc, iron, magnesium).

It can also be a consequence of a pedicure: the cuticle was pushed too far and the root of the nail was damaged. But in these cases, only a few vertical stripes stand out.

If more than 25% of the nails are affected by them, the health of the internal organs should be checked. First of all, the cardiovascular and digestive systems.

If the pathology is not of an infectious nature, you know its cause and have already started treatment, then you can give the damaged nails an aesthetic appearance. Any good salon has spa treatments for nails. For example, Japanese manicure (P-Shine) or paraffin therapy can be done to nourish and moisturize. For smoothness - grinding and polishing the nail plate.

el-corazon-ek.ru

This is koilonychia, that is, the deformation of the nail plate, in which its center bends, and the edges are turned upwards. It does not cause discomfort, color and smoothness are preserved, but it looks ugly.

The easiest way to detect koilonychia is to drip water onto the nail. Did the drop roll freely? Everything is fine. Is the drop stuck in the groove? There is a reason to think.

Most often, concave nails are the result of a lack of iron in the body and endocrine disorders. Acquired causes of koilonychia also include injuries, contact with chemicals, and sudden changes in temperature.

In addition, spoon-shaped nails can occur due to gene mutations and are inherited.

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Another name is the fingers of Hippocrates. This is a symptom in which the nail plates thicken and become like watch glasses. Moreover, if you look at the finger from the side, the angle between the posterior nail fold and the nail plate exceeds 180 °.

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Drum sticks are always a sign of a serious illness. They can manifest themselves in diseases of the lungs (from tuberculosis to cancer), heart and blood vessels (heart defects, endocarditis and others), gastrointestinal tract (ulcerative colitis, Crohn's disease and others).

9. Detachment of the nail

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In medicine, this is called onycholysis - a violation of the connection between the nail and the nail bed, when a void forms between them, and the nail plate changes color.

Trauma is the cause in 60% of cases. When struck, the vessels in the dermis are compressed, the nutrition of the nail is disturbed, its chemical composition and elasticity change. Another 30% is accounted for by fungal diseases and allergic reactions. The remaining 10% of onycholysis develops due to systemic somatic diseases.

When the nail plate begins to rise up, it no longer covers the nail bed that feeds it. This can lead to infection. If you have bumped or had any contact with chemicals and suddenly noticed that the nail began to flake off, you need to use antifungal and regenerating agents as soon as possible.
Olga Aleinikova, nurse, master of manicure and pedicure

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This is the name of a syndrome in which half of the nail plate is white, and half, closer to the tip, is brownish.

The most likely cause is kidney failure, due to which the number of blood vessels under the nails increases and they show through the nail plate.

Also, "half" nails are found in people and those who have undergone chemotherapy.

A change in the color of the nail plate is a signal that it is time to take care of health.

If your nails are suddenly white, it is worth checking the digestive and cardiovascular systems and paying particular attention to the liver. A yellow tint also provokes liver diseases, as well as pathologies of the endocrine and lymphatic systems. Cyanosis indicates a lack of oxygen, low hemoglobin levels, or poor circulation.

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Most often, a black stripe appears on the nail plate due to injury or malfunction. And for some peoples, this is completely a feature of the natural pigmentation of the skin.

But if you eat normally, did not hit anywhere, and blackening suddenly appeared on the nail, it is better to consult a doctor. This could be a symptom of melanoma, a malignant skin cancer.

How to maintain the beauty and health of your nails

Proper nutrition, healthy sleep and exercise should be the default. Check your nail plates regularly and take care of your hands.

Get a manicure and pedicure. Timely trim or file the free edge of the nails, process the cuticles.
Don't bite your nails.
Wear gloves when handling chemicals and when digging in the garden beds.
Take vitamins.
Apply a nourishing cream to your hands and nails regularly.
Don't wear tight shoes, stick your toes in crevices, and be careful with a hammer.

When going out to crowded places, use liquid gloves (this is such an emulsion). The risk of contracting infectious diseases through the hands is now very high.

If you see signs of ill health on the nail plates, use antifungal agents and regenerating drugs. If the pathology is persistent, be sure to get tested and see a doctor.

Nails are a mirror reflecting the state of human health, and are often the first to indicate serious diseases of the body. Diseases of the nails, in which their color changes, always cause great discomfort in a person and significantly reduce his quality of life.

Normal nail plates are pale pink in color. They are shiny and have a slight pallor in the center. There is a white nail cushion at the rear edge.

Pigmentation of the nail itself, as a primary change, is inherent in people of some nationalities.

Melanin, hemosiderin and hepatogenic pigments accumulated under its bed give a different color to the nail.

The color of the nail plates changes in a number of diseases. The most common cause of discoloration is associated with a fungal infection (onychomycosis). They change color, texture, shape and thickness. At different stages of the development of the disease, these changes are expressed in one form or another. Psoriasis ranks second in terms of loss of primary nail color.

Change in nail color with fungal infection

Among all diseases that occur with a change in the color of the nails, onychomycosis is most common. With these diseases, the color changes, shine is lost, stripes and spots appear, the thickness of the nail plates increases. Over time, they deform, crumble, collapse or are torn away from the nail bed.

More often, with a fungal infection, the nail plates acquire a yellowish or brown color. With trichophytosis - dirty gray. With rubromycosis and favus - yellow coloration.

Rice. 1. In the photo, onychomycosis (normotrophic type). The nail plate retains its configuration for a long time. In its depth, spots and stripes of white or rich yellow are visible. Over time, the areas with the changed color merge.

Rice. 2. The photo shows a nail disease caused by the fungi Trichophyton rubrum (onycholytic type). The nail plate quickly loses its original color and fades, acquiring a whitish or whitish-yellowish color. There is a rapid separation of the nail plate from the nail bed from the side of the free edge.

Rice. 3. In the photo, onychomycosis (hypertrophic type). This form of the disease is the most common. Up to 90% of cases are caused by fungi of the genus Trichophyton rubrum. The development of subungual hyperkeratosis entails a significant thickening of the nail, which eventually loses substance, which makes the surface "eaten away". Whitish spots and stripes of white and yellow are visible in its thickness.

Rice. 4. The photo shows white superficial onychomycosis. The second most common form of onychomycosis. In 90% of cases, the disease is caused by a fungus of the genus Trichophyton interdigitale, which affects only the upper layer of the nail plate, which never thickens or separates from the skin. Over time, its entire surface becomes loose, like a chalk powder.

Change in nail color with psoriasis

The causes of psoriasis have not yet been established. The disease is considered multifactorial. There is no doubt that changes in the immune system play an important role in the development of the disease. In psoriasis, nail plates change long before the onset of the main manifestations of the disease - psoriatic plaques on the skin. The more the matrix is involved in the pathological process, the more pronounced is the change in the nail plate, which over time completely loses its structure and color.

Rice. 5. In the photo there is a disease of nails in psoriasis. A characteristic sign of primary psoriasis is that a narrow reddish-pinkish strip appears through the nail plate.

Rice. 6. The photo shows a disease of nails with psoriasis. A reddish or salmon-colored coloration is visible under the nail plate, resembling a drop of oil in shape.

Rice. 7. In the photo there is an erythematous-spotted form of psoriasis. Yellowish spots are visible through the nail plate.

Rice. 8. In the photo there is a disease of nails in psoriasis. The structure of the nail plate on the side of the matrix is destroyed, the non-destroyed part has acquired a smoky color.

Diseases of the nails in which the nail plates have white spots (leukonychia)

Leukonychia is called the staining of the nail plates in white - from point and strip-like to total.

Most often occurs punctate leukonychia... It is caused by injuries during manicure. Point leukonychia occurs as a result of exposure to certain chemicals. Often, the cause of point leukonychia cannot be identified.

Point leukonychia can transform into striped leukonychia... It is assumed that this type of nail color change is associated with trophic changes. White stripes on the nails appear with arsenic and thallium poisoning.

Total staining of nails in white(white nails or Terry's nails) in 80% of cases appear in patients with liver cirrhosis. They are a symptom of kidney and heart failure, diabetes mellitus, iron deficiency anemia, and malnutrition. A white coloration of the nail bed is seen with chemotherapy and overproduction of thyroid hormones. Scientists believe that Terry's nails appear with a decrease in the number of blood vessels and an overgrowth of connective tissue in the nail bed. At the same time, the nails become matte. Often the white color of the nail plates is found in onychomycosis.

Rice. 9. In the photo there are white spots on the nails (punctate leukonychia).

Rice. 10. In the photo there are white spots on the nails (striped leukonychia).

Rice. 11. The photo shows white superficial onychomycosis. In 90% of cases, the disease is caused by a fungus of the genus Trichophyton interdigitale, which affects only the upper layer of the nail plate, which becomes loose, like chalk powder.

Rice. 12. In the photo there are white “Terry's nails”. Total staining white in 80% of cases appears in patients with liver cirrhosis.

Rice. 13. The photo shows psoriasis. The nail plate is destroyed and has a grayish-white color.

Rice. 14. In the photo there are arched lines on the nail plates (Mürke's lines). Occur in patients with a reduced amount of protein in the blood. When the amount of protein is normalized, the lines disappear.

Diseases of the nails in which the nail plates are yellow ("yellow" nails)

A yellow color appears with a fungal infection, when the cause of the disease is red trichophyton and some types of aspergillus molds.

Yellow coloration is observed in bronchiectasis, sinusitis, thyroid diseases and tuberculosis. It is often a sign of jaundice.

The yellow color of the nail plate becomes with the frequent use of low-quality varnish.

With defects in the development of the lymphatic system, the nails slow down their growth, thicken, lose transparency, acquire a yellow color, and the hole disappears. The disease is accompanied by edema of the upper limb and periungual ridge.

Rice. 15. In the photo there are yellow nail plates with a fungal infection.

Rice. 16. In the photo, yellow nail plates are one of the syndromes in a number of diseases.

Diseases of the nails in which the nail plates are brown ("brown" nails)

Brown staining of the nail plates is most often observed in onychomycosis caused by red trichophyton, chronic renal failure (in 40% of cases) and Addison's disease.

Nails acquire a brownish color in women during pregnancy, surgical interventions for diseases of the female genital organs, diabetes mellitus, malnutrition, thyroid disease, with the frequent use of low-quality varnish, the use of certain medications (gold preparations, zidovudine, anthracyclines, etc.) ...

The nail plates acquire a brown-green tint with candidiasis and aspergillosis.

Rice. 17. In the photo there is a nail disease - onychomycosis.

Diseases of the nails in which the nail plates are green ("green" nails)

The nails acquire a black-green color when they develop in the loose structure of the nail. Aspergillus mushrooms give the nail plates white, brown, green or black color. With the disease, the nails of the first three toes are more often affected. Whitish spots or stripes are visible on their surface. Over time, the surface itself becomes soft, powdery and crumbly grayish, brownish or green in color.

Rice. 18. The photo shows a nail disease caused by molds of the genus Aspergillus.

Rice. 19. The photo shows a nail disease caused by fungi of the genus Candida albicans. The fungus colonizes weakened areas. Most often, the nail plates on the hands are affected, which become discolored or acquire a brownish or greenish color and thicken. Sometimes the surrounding skin is affected, causing painful sensations. Wearing artificial nails contributes to the disease.

Rice. 20. The photo shows a disease of the nails caused by Pseudomonas aeruginosa (pseudomonas onychia). Pseudomonas aeruginosa colonizes the cavities of the nail plates.

Diseases of the nails in which the nail plates are gray-blue or blue ("blue" nails)

When using antibiotics of a wide spectrum of action of tetracycline and minomycin, the nails are painted blue, in a dirty gray color - with trichophytosis.

The nail plates acquire a gray-blue color when taking the antimalarial drug akriquine and the antiprotozoal drug chloroquine.

The color changes with an increase in methemoglobin in the blood. In some cases, methemoglobinemia develops in acute poisoning with aniline dyes, paracetamol, potassium permanganate, etc. and chronic intoxication with silver compounds (argyria). There is congenital methemoglobinemia.

Rice. 21. In the photo, the nail plates have a gray-blue color.

Rice. 22. The photo shows a nail disease caused by taking Minocycline.

Rice. 23. The photo shows Wilson-Konovalov's disease, in which an overabundance of copper in the body leads to its accumulation in many organs, including nails and the cornea of the eye.

Rice. 24. The photo shows a bluish color of all nail plates with insufficient peripheral circulation (hypoxemia), which is most often caused by chronic heart failure. A bluish coloration of the peripheral parts of the body is noted on the hands, tip of the nose, lips and auricles.

Diseases of the nails in which dark streaks appear (melanonychia)

Melanonychia appears at the age of 20 in 77% of people with black skin. However, if this happens to a fair-skinned person, you need to be wary. In this case, it is necessary to exclude melanoma - the most malignant tumor in the world. This tumor, as it grows, affects the nail bed and is called subungual melanoma. The color always changes on one nail plate. Most often, the causes of melanonychia remain unknown.

Rice. 25. In the photo there are longitudinal dark stripes (melanonychia).

Rice. 26. The photo shows a subungual melanoma (left) and a subungual hematoma - the result of an injury (right).

Rice. 27. The photo shows subungual melanoma.

Rice. 28. The photo shows subungual melanoma.

Rice. 29. In the photo there are red thin stripes. A similar pattern is created when tiny blood vessels are damaged due to trauma. But if the stripes are present on all nails, then this may be a symptom of lupus erythematosus, psoriasis and endocarditis.

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