Nail Diseases

2024/10/01

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What is Nail Diseases?

Nail Disorders can occur alone or associated with skin conditions.

Common diseases of the nails include:

Nail infection by bacteria, fungi or yeast.
Paronychia - an infection of the nail fold. This type of infection usually results from injury to the nail fold. Causes of injury include habitual biting or overexposure to moisture. People whose hands are exposed to water most of the time (such as. housewives, canteen operators and cooks) are more prone to develop paronychia.
Nail disorders due to skin disease e.g., psoriasis
Injury to the nail

Symptoms

Nail Infections

Signs and symptoms include discoloration of the nail plate, brittleness, thickening, lifting of the nail plate and pain.

Paronychia

Symptoms include pain, swelling and redness of the nail fold. Sometimes pus may form.

Nail disorders due to skin disease eg. Psoriasis

Signs and symptoms include pitting, lifting of the nail plate, brownish discoloration, nail plate thickening and brittleness.

Nail Injury

Signs and symptoms include pain, bleeding, bruising, nail plate detachment and discolouration (from bleeding in the nail bed)

When to seek medical advice

See your doctor if:

You're so uncomfortable with the condition that it affects your quality of life
There is widespread involvement
Self-care methods have not been effective

Treatment and drugs

Nail Infections

Nail infections can be assessed and confirmed by laboratory microscopic examination of clippings of the nail. Topical antibiotic and topical antifungal solutions are often used as first line in mild cases affecting only a few nails, while laboratory culture tests are pending. In more severe cases, oral antifungal tablets and antibiotic tablets maybe used. Treatment may last several months depending on the type of infection and the oral medication.

Paronychia

Treatment of paronychia includes draining pus in the infected nail fold and oral antibiotics. Topical antifungal and antiseptic lotions may be used to treat paronychia. Patients with paronychia must avoid prolonged wet-work and injury to the hands. Wearing of gloves during wet work helps to prevent paronychia.

Nail disease as part of another skin condition

Topical agents (eg. Topical steroids, Vitamin D analogues and topical calcineurin inhibitors) can be applied on the affected nails. Intralesional injections with steroids can also help. In more severe and widespread cases oral and injectable medications may be used depending on the underlying skin condition and severity.

Nail Injury

Bruising and blood clots are often managed conservatively if there are no symptoms. An acute painful blood clot can be drained surgically. The entire nail plate can also be removed surgically if necessary.

Doctors