Nail diseases (overview) L60.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Diseases of the nail organ; Diseases of the nails

Definition
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Change of the nail plate(s) in the context of integumentary or general (systemic) diseases occurring or as an independent entity limited to the nail organ. See also the respective clinical picture. S.a. Nail care.

Classification
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Onychodystrophies (changes in the nail plate)

  • Longitudinal grooves (special form: Dystrophia mediana canaliformis); frequent growth disturbance of the nails also due to age. Can lead to triangular tears and splintering at the free edge of the nail.
  • Transverse grooves(Beau-Reilsche transverse furrows of the nails)
  • Onychauxis (nail thickening while maintaining transparency)
  • Leukonychia punctata
  • linear leukonychia
  • Lunulae triangulares (triangular lunulae, e.g. in nail-patella syndrome)
  • Onychisis (lamellar splitting of the nail in longitudinal and transverse direction, see below) onychorrhexis)
  • Onycholysis (detachment of the nail plate - for causes see there)
  • Atrophy of the nail plate up to anonychia (often with pterygium formation)
  • Soft, brittle nails (iron deficiency anaemia, vitamin A overdoses)
  • Onychorrhexis (hard, thickened and splintering nails)
  • Pachyonychia congenita
  • Tubular nail (unguius in turricolo)
  • Watch glass nails(see also macroonychia)

Nail signs due to diseases of the nail bed

Diseases of the peri- paro and epinychium

  • bulla repens
  • Fibrokeratome digital acquired
  • Paronychia in dyskeratosis congenita (rare)
  • paronychia, bacterial
  • paronychia candidamycetica
  • paronychia, syphilitic (blistery or pustular skin changes with infestation of the paronychium and nail detachment in syphilis connata)
  • Hyperkeratotic nail fold (in dermatomyositis and progressive systemic scleroderma)
  • Megacapillaries in dermatomyositis and progressive systemic scleroderma

Nail discoloration see below Chromonychia

Congenital and hereditary nail diseases (see also under"Genetically caused non-syndromal nail abnormalities")

Nail dystrophies in dermatological diseases

Nails for internal diseases

The painful nail (definition: common and unspecific symptom of many changes in the nail apparatus. Pressure pain of the nail or the nail wall are symptoms of different diseases).

tumours of the soft tissue and bones:

Vascular causes:

Traumatic nail changes

  • Polishing or shiny nails (due to constant rubbing of the nails, e.g. in atopic eczema due to scratching)
  • Traumatic onycholysis
  • Median nail dystrophy
  • Onychogrypose (big toe or 2nd toe for soccer players)
  • Subungual haematomas
  • Unguis incarnatus
  • Retronychie
  • Splinters and other foreign bodies
  • Chronic injuries of the nail matrix by sports shoes (due to frequent bumping of the toes)
  • Traumatic nail bruises due to dorsal or frontal pressure events.
  • Nail misalignment in childhood

Nail tumours (periungual or subungual)

  • Granuloma pyogenicum
  • Periungual or subcutaneous warts
  • Fibromas, periunguale (traumatic)
  • Juvenile fibroids
  • Koenen tumor with M. Pringle
  • Subungual exostoses
  • Subungual osteochondrome
  • Glomus tumor
  • Melanocytic nevi
  • Bowen's disease
  • Verrucous carcinoma
  • Acrolentiginous malignant melanoma

Literature
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  1. Altmeyer P (2012) Dermatological differential diagnosis. Springer, Heidelberg, New York
  2. Daniel CR et al (1985) Nails in systemic disease. Dermatol Clin 3: 465-483
  3. Effendy I (2003) Nail changes during childhood. dermatologist 54: 41-44
  4. Helfand AE (2003) Assessing onychial disorders in the older patient. Clin Podiatry Med Surgery 20: 431-442
  5. Langnickel R (2002) The yellow-nail syndrome. Laryngorhinootology 81: 56-59

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020