Introduction:

The nails are gift at the end of every finger tip on the dorsal surface.The main perform of nail is protection and it also helps for a firm grip for holding articles.It consists of a sturdy relatively flexible keratinous nail plate originating from the nail matrix. Under the nail plate there’s a soft tissue called nail bed.Between the skin and nail plate there’s a nail fold or cuticle.Normal healthy nail is slight pink in color and also the surface is convex from side to side.Finger nails grow 1 cm in 3 months and toe nails take 24 months for the same.

Importance of nails in disease diagnosis:

The colour ,look,form and nature of the nails offer some information about the final health and hygiene of a person . Nails are examined as a routine by all doctors to get some clues regarding underlying diseases.Simply looking at nails we have a tendency to will makeout the hygiene of a person.The abnormal nail may be congenital or because of some diseases.The cause for changes in the nail extend from straightforward reasons to life threatening diseases.Hence the examination by a doctor is essential for diagnosis .Some abnormal findings with probable causes are discussed here for general awareness.

one) Hygiene:-

We have a tendency to can build out an unhygienic nail very simply .Deposition of dirt below the distal finish of nail plate will make a probability for ingestion of pathogens while eating.If nail filing isn’t done properly it can result in worm troubles in children.When the worms crawl within the anal orifice kids will scratch that lodges the ova of worms below the nails and can be taken in while eating.Outstanding nail can also complicate a skin disease by habitual scratching.Sharp nails in little kids cause little wounds after they do feet kicking or hand waving.

two) Colour of the nails:-

a) Nails become pale in anaemia.

b) Opaque white discolouration(leuconychia) is seen in chronic renal failure and nephrotic syndrome.

c) Whitening is also seen in hypoalbuminaemia as in cirrhosis and kidney disorders.

d) Drugs like sulpha cluster,anti malarial and antibiotics ect will turn out discolouration in the nails.

e) Fungal infection causes black discolouration.

f) In pseudomonas infection nails become black or green.

g) Nail bed infarction occures in vasculitis especially in SLE and polyarteritis.

h) Red dots are seen in nails because of splinter haemorrhages in subacute bacterial endo carditis, rheumatoid arthritis, trauma, collagen vascular diseases.

i) Blunt injury produces haemorrhage and causes blue/black discolouration.

j) Nails become brown in kidney diseases and in decreased adrenal activity.

k) In wilsons disease blue color in semicircle seems within the nail.

l) When the blood offer decreases nail become yellow .In jaundice and psoriasis additionally nail become yellowish.

m) In yellow nail syndrome all nails become yellowish with pleural effusion.

three) Shape of nails:-

a) Clubbing: Here tissues at the base of nails are thickened and therefore the angle between the nail base and the skin is obliterated. The nail becomes a lot of convex and also the finger tip becomes bulbous and appearance like an end of a drumstick. When the condition becomes worse the nail appearance sort of a parrot beak.

Causes of clubbing:-

Congenital Injuries

Severe chronic cyanosis

Lung diseases like empyema,bronchiactesis,carcinoma of bronchus and pulmonary tuberculosis.
Abdominal diseases like crohn’s disease,polyposis of colon,ulcerative colitis,liver cirrhosis ect…

Heart diseases like fallot’s tetralogy,subacute bacterial endocarditis and ect..

b) Koilonychia:-

Here the nails become concave like a spoon.This condition is seen in iron deficiency anaemia.In this condition the nails become thin,soft and brittle.The normal convexity will be replaced by concavity.

c) Longitudinal ridging is seen in raynaud’s disease.

d) Cuticle becomes ragged in dermatomyositis.

e) Nail fold telangiectasia could be a register dermatomyositis ,systemic sclerosis and SLE.

4) Structure and consistancy:-

a) Fungal infection of nail causes discolouration,deformity,hypertrophy and abnormal brittleness.

b) Thimble pitting of nail is charecteristic of psoriasis ,acute eczema and alopecia aereata.

c) The inflamation of cuticle or nail fold is called paronychia.

d) Onycholysis is the seperation of nail bed seen in psoriasis,infection and after taking tetracyclines.

e) Destruction of nail is seen in lichen planus,epidermolysis bullosa.

f) Missing nail is seen in nail patella syndrome.It is a hereditary disease.

g) Nails become brittle in raynauds disease and gangrene.

h) Falling of nail is seen in fungal infection,psoriasis and thyroid diseases.

five) Growth:-

Reduction in blood offer affects the expansion of nails. Nail growth is additionally affected in severe ilness. when the disease disappears the expansion starts again ensuing in formation of transverse ridges.These lines are known as Beau’s lines and are healpful so far the onset of illness.

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