Nails in health and illness.

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Nails
Nails

Introduction: 

 The nails are located at the end of each toe on the back. The main function of the nail is protection and it also helps in maintaining a firm grip on objects. It is a strong and relatively flexible keratin nail plate obtained from the nail matrix. Beneath the nail plate is a soft tissue called the nail bed. Between the skin and the nail plate is the nail fold or cuticle.A normal, healthy nail is slightly pink and its surface is convex from side to side. Fingernails grow 1 cm in three months and toenails grow in 24 months. 

The importance of nails in the diagnosis of diseases: 

The color, appearance, shape and condition of nails provide information about a person's general health and hygiene. Nails are examined regularly by all doctors for evidence of underlying diseases. Just by looking at the nails, you can judge a person's hygiene. An abnormal nail can be congenital or the result of certain diseases.The causes of nail changes range from simple causes to life-threatening diseases. A medical examination is therefore necessary to make a diagnosis. Some unusual findings are discussed here along with likely causes to increase general awareness. 

 1) Hygiene:- 
 You can easily recognize a diseased nail. The accumulation of dirt under the distal end of the nail plate poses a risk of ingesting pathogens when eating. If nails are not trimmed properly, children may develop worm problems.When worms enter the anal opening, children scratch themselves, resulting in worm eggs under their nails, which are ingested when eating. A protruding nail can also lead to complications from skin diseases caused by habitual scratching. Small children's sharp nails cause small cuts when they kick or flail their arms. 

 2) Nail Color:- 
 a) With anemia, the nails become pale. 
 b) A dull white discoloration (leukonia) occurs in chronic kidney failure and nephrotic syndrome. 
 c) Whitening is also observed in hypoalbuminemia, liver cirrhosis and kidney disease. 
 d) Medicines such as sulfonamides, antimalarials, antibiotics, etc. can cause discoloration of the nails. 
 e) A fungal infection causes a black color. 
 f) With a Pseudomonas infection, the nails turn black or green. 
 g) Nail bed infarction occurs in vasculitis, especially in SLE and periarteritis. 
 h) Red dots appear on the nails due to ruptured hemorrhages in subacute bacterial endocarditis, rheumatoid arthritis, trauma, collagen vascular diseases. 
 i) Blunt trauma causes bleeding and blue-black discoloration. 
 j) In cases of kidney disease and reduced activity of the adrenal glands, the nails turn brown. 
 k) In Wilson's disease, a blue semicircular color appears on the nail. 
 l) When the blood supply decreases, the nails turn yellow. In cases of jaundice and psoriasis, the nails also turn yellowish. m) In yellow nail syndrome, all nails turn yellowish due to a pleural effusion. 

  3) Shape of nails:- 
a) Clubbing: In this case, the tissue at the base of the nail thickens and the angle between the nail base and the skin becomes blurred. The nail becomes more convex and the fingertip becomes bulbous, resembling the end of the lower leg. If the situation worsens, the nail resembles a parrot's beak. Reasons to visit a club:- Congenital lesions Severe chronic cyanosis lung diseases such as empyema, bronchiectasis, bronchial cancer and pulmonary tuberculosis. abdominal diseases such as Crohn's disease, colorectal polyposis, ulcerative colitis, liver cirrhosis, etc. Heart diseases such as tetralogy of Fallot, subacute bacterial endocarditis and others. 
 b) Koilonichia:- Here the nails become concave like a spoon. This condition manifests itself as iron deficiency anemia. Under these conditions, nails become thin, soft and brittle. The normal convexity is replaced by the concave convexity. 
 c) Longitudinal stripes are observed in Raynaud's disease. 
 d) The epidermis breaks down in dermatomyositis. 
 e) Telangiectasia of the nail folds is a sign of dermatomyositis, systemic sclerosis and SLE. 

  4) Structure and Consistency:- 
a) Fungal infection of the nails results in discoloration, deformation, excessive growth, and abnormal brittleness. 
b) Pitting of the nails is characteristic of psoriasis, acute eczema and alopecia areata. 
 c) Inflammation of the cuticle or nail folds is called paronychia. 
 d) Onycholysis is the detachment of the nail bed, which is observed in psoriasis, infections and after taking tetracyclines. 
 e) Destruction of the nails is observed in lichen planus and epidermolysis bullosa. 
 f) The absence of a nail manifests itself as nail-patella syndrome. It is a hereditary disease. 
 g) Nails become brittle in Raynaud's disease and gangrene. 
 h) Falling nails are observed in fungal infections, psoriasis and thyroid diseases. 

  5) Size:- 
Decreased blood supply affects nail growth. Serious illnesses also affect nail growth. When the disease subsides, growth resumes and forms transverse stripes. These lines are called Beau's lines and help determine the onset of the disease.
Location: United States

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