By Gary M. White, MD
The nail serves many purposes--both functional and aesthetic. It is a protector of the finger against trauma, and it may be used as a tool for manipulation of objects. The nail is commonly used for cosmetic adornment and with it a proxy for social status. Clinically, the nails may be valuable as a marker of systemic disease or a window into the underlying psyche. For example, social and psychological dysfunction may manifest as inattention to the cleanliness or maintenance of the nail plate, while behavioral disorders may present with the stigmata of repetitive injury, e.g. onychotillomania. See also lunula.
Congenital Onychodysplasia of the Index Finger
Isolated Congenital Nail Dysplasia
Congenital Hypertrophy of the Nail Fold
Koilonychia. So called "spoon nails."
Parrot-Beak Nail. Longitudinal hypercurvature of the nails occurs in the parrot-beak nail.
Post trauma [Dermatology Online Journal].
Lichen Striatus. Usually in a child.
Onychotillomania. In onychotillomania the patient picks constantly at the nails or tries to tear them off. It is not the same as onychophagia, where the patient bites the nails.
Digital Mucous Cyst
Acquired Periungual Fibrokeratoma
Congenital Malalignment of the Great Toenail
For further discussion of both solitary and polydactylous longitudinal erythronychia, see here.
Onycholysis. Women with long nails classically get this.
Pseudomonas. Secondary infection of onycholysis.
Onychomycosis. Fungal infection of the nail can cause separation of the nail plate from the bed. There may be other signs of onychomycosis including subungual debris and nail dystrophy as shown here.
Photoonycholysis. A photosensitizing drug and the sun causes the onycholysis.
Longitudinal Melanonychia of various causes.
Nail Apparatus (Subungual) Melanoma. Advanced, showing destruction of the nail.
Frictional Melanonychia. The lateral part of the 4th or 5th toe, where the shoe rubs, is the classic place for this.
Onychocytic Matricoma. For a picture, see JAMA Derm 2014;150;336
Onychopapilloma. For a picture, see JAAD January 2011 Volume 64, Issue 1, Pages 167.e1–167.e11
Drug-Induced Nail Pigmentation. Minocycline taken for 3 years for rosacea caused this bluish discoloration of the nails.
Topical 5-FU can induce melanosis of the nail. This child was treated with topical 5-FU for periungual warts and developed nail pigmentation near the proximal nail fold. The pigment has grown out now over several months and will soon be shed.
Longitudinal Ridging, Nails
Median Canalicular Dystrophy
Habit Tic Deformity
Chronic Mucocutaneous Candidiasis
Various drugs can turn the nails blue including minocycline, AZT, 5-fluorouracil, and antimalarials.
Wilson's Disease: A bluish discoloration of the lunula may develop in hepatolenticular degeneration (Wilson's disease).
Pseudomonas. See above.
Half And Half Nails
Mees' Lines (Transverse Leukonychia)
White Superficial Onychomycosis
Proximal Subungual Onychomycosis
Endonyx Onychomycosis. For a picture, see Indian J Dermatol Venereol Leprol 2015;81:390-2
Nail Discoloration. Many contactants may turn nails yellow, orange-brown, gray-blue, purple, red, black, or green. Gold therapy can turn the nails yellow.
Yellow Nail Syndrome
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