Nail disease

Nail diseases are in a separate category from diseases of the skin. Although nails are a skin appendage, they have their own signs and symptoms which may relate to other medical conditions. Nail conditions that show signs of infection or inflammation require medical assistance and cannot be treated at a beauty parlor. Deformity or disease of the nails may be referred to as onychosis.

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Onychia without granuloma
  • Onychia is an inflammation of the matrix (surrounding tissue) of the nail with formation of pus and shedding of the nail. Onychia results from the introduction of microscopic pathogens through small wounds.


  • Onychocryptosis, commonly known as "ingrown nails" (unguis incarnatus), can affect either the fingers or the toes. In this condition, the nail cuts into one or both sides of the nail bed, resulting in inflammation and possibly infection. The relative rarity of this condition in the fingers suggests that pressure from the ground or shoe against the toe is a prime factor. The movements involved in walking or other physical disturbances can contribute to the problem. Mild onychocryptosis, particularly in the absence of infection, can be treated by trimming and rounding the nail. More advanced cases, which usually include infection, are treated by surgically excising the ingrowing portion of the nail down to its bony origin and cauterizing the matrix, or 'root', to prevent recurrence. This surgery is called matricectomy. The best results are achieved by cauterizing the matrix with phenol. Another method, which is much less effective, is excision of the matrix, sometimes called a 'cold steel procedure'.
  • Onychodystrophy is a deformation of the nails that can result from cancer chemotherapy which includes bleomycin, hydroxyurea, or 5-fluorouracil.
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Grphyphotic nail with mycotic changes
  • Onychogryposis, also called "ram's-horn nail", is a thickening and increase in curvature of the nail. It is usually the result of injury to the matrix. It may be partially hereditary and can also occur as a result of long-term neglect. It is most commonly seen in the great toe but may be seen in other toes as well as the fingernails. An affected nail has many grooves and ridges, is brownish in color, and grows more quickly on one side than on the other. The thick curved nail is difficult to cut, and often remains untrimmed, exacerbating the problem.


  • Onycholysis is a loosening of the exposed portion of the nail from the nail bed, usually beginning at the free edge and continuing to the lunula. It is frequently associated with an internal disorder, trauma, infection, nail fungi, allergy to nail enhancement products, or side effects of drugs.
  • Onychomadesis is the separation and falling off of a nail from the nail bed. Common causes include localized infection, minor injury to the matrix bed, or severe systemic illness. It is sometimes a side effect of chemotherapy or x-ray treatments for cancer. A new nail plate will form once the cause of the disease is removed.
  • Onychomycosis, also known as tinea unguium, is a contagious infection of the nail caused by the same fungal organisms which cause ringworm of the skin. It can result in discoloration, thickening, chalkiness, or crumbling of the nails and is often treated by powerful oral medications with can cause severe side effects, including liver failure, although it sometimes responds to a combination of topical medication and periodic filing of the nail surface. The best treatment is to apply two drops of distilled white vinegar to the nail base twice a day for approximately six months or until the fungus is gone. This treatment is very effective but only if followed consistently.
  • Onychophosis is a growth of horny epithelium in the nail.
  • Onychoptosis is the periodic sheddng of one or more nails, in whole or part. This condition may follow certain diseases such as syphilis, or can result from fever, trauma, systemic upsets or adverse reaction to drugs.
  • Paronychia is a bacterial or fungal infection where the nail and skin meet. Pus is usually present, along with gradual thickening and browning discoloration of the nail plate. Paronychia around the entire nail is sometimes referred to as runaround paronychia. Chronic paronychia is most often caused by a yeast infection of the soft tissues around the nail but can also be traced to a bacterial infection. Individuals who work with their hands in water, such as health care workers and food processors, are quite prone to this type of infection.
  • Koilonychia is when the nail curves upwards due to an iron deficiency.
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Subungual hematoma (mild)
  • Subungual hematoma occurs when trauma to the nail results in a collection of blood, or hematoma, under the nail. It may result from an acute injury or from repeated minor trauma such as running in undersized shoes. Acute subungual hematomas are quite painful, and usually are treated by releasing the blood via a hole drilled in the nail.


Diseases with characteristic nail changes

  • Psoriasis is associated with pitting of the nails.

External links

  • Ingrown Toenail (http://www.mckinley.uiuc.edu/health-info/dis-cond/misc/ingrowto.html) - explanation covering causes, treatment, and prevention (with diagram)
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