NAILS: Their Role in Health and Disease
At the tips of our fingers lies a protective layer called the nail.
Apart from providing protection, nails also aid in holding objects firmly.
They are made up of a flexible keratinous nail plate that originates from the nail matrix, with a soft tissue called the nail bed lying beneath it.
The area between the skin and the nail plate is the nail fold or cuticle. Normally, healthy nails have a slight pinkish hue, with a convex surface.
The growth rate of fingernails is approximately 1 cm in three months,
while toenails take about 24 months to grow the same length.
Nails and Disease Diagnosis
The color, appearance, shape, and condition of nails can provide valuable information about a person's overall health and hygiene.
Doctors routinely examine nails to obtain clues about underlying diseases.
Just by looking at a person's nails, one can determine their level of hygiene. Abnormal nails can be congenital or due to an underlying disease.
The causes of nail changes range from simple reasons to life-threatening illnesses, and a doctor's examination is essential for proper diagnosis.
Here are some common
abnormal findings:
1-Hygiene:
Nails that are not kept clean can easily accumulate dirt under the distal end of the nail plate, which increases the chances of ingesting pathogens while eating.
Improper nail cutting can also result in worm troubles in children, as they may scratch the area, lodging the ova of worms under their nails, which can then be ingested while eating.
Prominent nails can
further complicate a skin disease by habitual scratching, and sharp nails in
small children can cause small wounds when they kick or wave their hands.
2-Nail Color:
a) Anemia can cause nails to become pale.
b) Chronic renal failure and nephrotic syndrome can
result in opaque white discoloration (leuconychia).
c) Hypoalbuminemia, as seen in cirrhosis and kidney
disorders, can also cause whitening.
d) Discoloration in the nails can be caused by drugs
such as the sulpha group, antimalarials, and antibiotics.
e) Fungal infections can cause black discoloration.
f) Pseudomonas infections can cause nails to turn
black or green.
g) Nail bed infarction is seen in vasculitis,
especially in SLE and polyarteritis.
h) Splinter hemorrhages can cause red dots in nails
and are seen in subacute bacterial endocarditis, rheumatoid arthritis, trauma,
and collagen vascular diseases.
i) Blunt injury can cause nail hemorrhage, leading to
blue/black discoloration.
j) Kidney diseases and decreased adrenal activity can
cause nails to become brown.
k) In Wilson's disease, a blue color in the semicircle
appears in the nail.
l) Reduced blood supply can cause nails to turn
yellow. Nails can also become yellowish in jaundice and psoriasis.
m) Yellow nail syndrome causes all nails to turn
yellowish with pleural effusion.
3-Nail Shape:
a) Clubbing: In this condition, tissues at the base of the nails become thickened, and the angle between the nail base and the skin is obliterated.
The nail becomes more convex, and the fingertip becomes bulbous, resembling the end of a drumstick.
With further progression, the nail may
resemble a parrot beak.
4-Causes of clubbing:
Congenital injuries
Severe chronic cyanosis
Lung diseases like empyema, bronchiectasis, carcinoma
of bronchus, and pulmonary tuberculosis.
Abdominal diseases like Crohn's disease, polyposis of
colon, ulcerative colitis, liver cirrhosis, etc
Conclusion:
In conclusion, our nails play a crucial role in protecting the tips of our fingers and toes, as well as providing a firm grip.
They also offer important clues about our general health and hygiene. Discoloration, deformity, brittleness, and other abnormalities in our nails can be indicative of underlying diseases, from simple reasons to life-threatening conditions.
It is therefore essential to regularly examine our nails and seek the advice of a doctor when we notice any concerning changes.
By
paying attention to our nails, we can better understand and address our overall
health and well-being.
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