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Nail Disorder and Diseases
Onychiais an inflammation of the nail folds (surrounding tissue of the nail plate) 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. ild onychocryptosis, particularly in the absence of infection,
can be treated by trimming and rounding the nail. ore advanced cases, which usually
include infection, are treated by surgically e!cising the ingrowing portion of the nail
down to its bony origin and thermally or chemically cauteriing the matri!, or #root#, to
prevent recurrence. This surgery is called matri!ectomy. The best results are achieved by
cauteriing the matri! with phenol. The $andenbos %rocedure is a highly effective
method that focuses on e!cision of e!cessive nail fold tissue without affecting the
healthy nail and nail matri!. The $andenbos procedure is showing high success rates in
eliminating Onychocryptosis without altering the normal nail. ¬her, much less
effective, treatment is e!cision of the matri!, sometimes called a #cold steel procedure#.
Onychodystrophyis a deformation of the nails that can result from
cancer chemotherapy which includes bleomycin, hydro!yurea, or'fluorouracil. It can
include discoloration of the nail, or dyschromia.
Onychogryposis, also called "ram#shorn nail", is a thickening and increase
in curvature of the nail. It is usually the result of inury to the matri!. It may be
partially hereditary and can also occur as a result of longterm neglect. It is most
commonly seen in the greattoe but may be seen in other toes as well as the fingernails.
&n affected nail has many grooves and ridges, is brownish in color, and grows more
*uickly on one side than on the other. The thick curved nail is difficult to cut, and often
remains untrimmed, e!acerbating the problem.
Onycholysisis a loosening of the e!posed portion of the nail from the nail bed, usually
beginning at the free edge and continuing to thelunula. It is fre*uently associated with
an internal disorder, trauma, infection, nail fungi, allergy to nail enhancement products,
or side effects of drugs.
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Onychomadesisis the separation and falling off of a nail from the nail bed.+ommon
causes include localied infection, minor inury to thematri! bed, or severe systemic
illness. It is sometimes a side effect of chemotherapy or !ray treatments for cancer. &
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 nailcaused by the same fungal organisms which causeringworm of the skin
(Trichophytonrubrumor T. mentagrophytes, rarely other trichophyton species
orEpidermophyton floccosum). It can result in discoloration, thickening, chalkiness, or
crumbling of the nails and is often treated by powerful oral medications which, rarely,
can cause severe side effects including liver failure. ild onychomycosis sometimes
responds to a combination of topical antifungal medication, sometimes applied as
special medicinal nail lac*uer, and periodic filing of the nail surface. or advanced
onychomycosis, especially if more than one nail is infected, systemic medication (pills)
is preferred. -ome remedies are often used, although their effectiveness is disputed.
Onychophosisis a growth of horny epithelium in the nail.
Onychoptosisis the periodic shedding of one or more nails, in whole or part. This
condition may follow certain diseases such assyphilis, or can result from fever,
trauma, systemic upsets or adverse reaction to drugs.
Onychorrhexisalso known as brittle nails, is brittleness with breakage of fingernails or
toenails.
Paronychiais a bacterial or fungal infection where the nail and skin meet.
Koilonychiais when the nail curves upwards (becomes spoonshaped) due to an iron
deficiency. The normal process of change is brittle nails, straight nails, spoonshaped
nails.
Subungual hematomaoccurs when trauma to the nail results in a collection of blood,
or hematoma, under the nail. It may result from an acute inury or from repeated
minor trauma such as running in undersied shoes. &cute subungual hematomas are
*uite painful, and are usually treated by releasing the blood by creating a small hole in
the nail. /rilling and thermal cautery are common methods for creating the hole.
Thermal cautery is not used on acrylic nails because they are flammable.Onychomatricoma, a tumor of the nail matri!.
Nail Pemphigus, an autoimmune disease.
Erythronychia, red bands in the nail from some inflammatory conditions.
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Melanonychia, a black or brown discoloration of the nail, with numerous causes.