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Treatment of Common Nail Diseases

Onychosis  Any disease or deformity of nail.
Onycholysis  Separation of nail plate from nail bed.
Onychia  Inflammation of the matrix of nails.
Onychogryphosis  Thickening of nails.
Onychomycosis  Fungal infection of nails.
Onychodystrophy  Degeneration of nails.
Subungual hyperkeratosis  Collection of keratotic debris under the nail plate.
Paronychia  Bacterial or fungal infection where the nail and skin meet.
Koilonychia  When the nail becomes concave spoon shaped (usually it is convex upward) due to iron deficiency anemia.
Onychorrhexis Splitting of nails
Onychoptosis defluvium (Alopecia unguim) Component of alopecia.

Important Nail Changes and Diseases Causing Them

Nail changes Pathology Causative disorders
o Koilonychia The nail is concave with raised edges (Spoon shaped nail) •  Iron deficiency anemia
•  Plummer vinson's syndrome
•  Sedropenic anemia
•  Hyperthyroidism
o Onycholysis Separation of nail from nail bed •  Psoriasis
•  Fungal infection
•  Trauma
•  Tetracycline (Photo-onycholysis)
o Pterygium Proximal nail fold extends onto and fuses with nail bed •  Dorsal pterygium in lichen planus
•  Ventral perygium in:-
- Scleroderma with Raynaud's phenomenon
- Causalgia of median nerve
- Trauma
o Anonychia Absence of all or part of one or several nails •  Lichen planus
o Racquet Nail Width of nail bed & nail plate is greater than length •  Premature obliteration of epiphyseal line
o Hook nail Lock of support from short bony phalanx
o Mee's line Transverse white line on nail Arsenic poisoning
o Beau lines Transverse depression on nail bed •  Trauma, surgery
•  Drugs
•  Pyrexia
•  Peripheral nerve injury
•  Eczema, erythroderma
•  Kawasaki syndrome
o Onychomadesis Separation of nail plate from matrix •  All causes of Beau lines
o Koenen's periungual fibroma o Tuberous sclerosis
o Leukonychia (True) White discolouration of nail (GIFT SPOTS) •  Nail matrix damage
- Traumatic
- Psoriasis
- Tight shoes
- Fungal infection
o Apparent leukonychia White appearance due to changes in underlying tissue. This may be -
•  Terry's type of leukonychia (terry's nail)
•  Half & Half nail
•  Banded nail (Muehrcke lines)
o Hepatic disorder
o Chemotherapeutic drugs
o Trachyonychia Nails are rough due to excessive longitudinal ridging, often thinned (Rough sand paper nail) •  Alopecia areata
•  Lichen planus
•  Psoriasis
•  Dermatitis
o Longitudinal ridges with beaded or fir tree appearance •  Median canaliform dystrophy of Heller

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