Hand Eczema's Impact: Can It Lead To Nail Loss?

Hand eczema is a common condition that can cause fingernail changes, which are more common than toenail changes. Nail problems are also associated with dyshidrotic eczema, a recurrent eczematous disorder of the hands and feet. These nail problems can include onycholysis (loosening or separation of a fingernail or toenail from its nail bed), yellowing, and pitting of the nails. It is important to note that nail changes are more common in patients with hand or foot eczema compared to those without the condition.

Nail changes in hand eczema patients: 9.1% have finger nail changes

Nail changes are more common in hand eczema patients than in those without the condition. 9.1% of hand eczema patients have finger nail changes, while 20% of foot eczema patients have toe nail changes.

Dyshidrotic eczema is a recurrent eczematous disorder of the hands and feet that is commonly seen in older children and adults. It is often seen in association with hyperhidrosis (excessive sweating). Patients have multiple small, intensely pruritic (itchy) vesicles on the palm of the hands, soles or digits. Maceration (softening and breaking down of the skin) and secondary infection are common due to severe pruritis (itching). Patients may also have nail problems, including onycholysis (loosening or separation of a fingernail or toenail from its nail bed), yellowing and pitting of the nails.

Nail eczema can cause pitting in the nails (dents that look like your nail was poked by an icepick), and requires treatment to avoid worsening of the condition. Pompholyx eczema can affect the nail folds and skin around the nails (cuticles), resulting in swelling. Onychorrhexis is the presence of longitudinal striations or ridging of the nails.

The inciting event causes complete cessation of nail matrix activity. Loss of the nail might or might not be permanent.

Dyshidrotic eczema can cause nail problems, including onycholysis (nail loosening)

Dyshidrotic eczema is a skin condition that causes itchy blisters on the palms, fingers, feet, and toes. It can also lead to red, cracked skin and changes in nail appearance. While there's no cure, treatments such as creams with steroids, antihistamines, or light therapy can help manage symptoms. Good hygiene, moisturizing, and avoiding triggers can also help control flare-ups.

Dyshidrotic eczema can cause nail problems, including onycholysis (loosening or separation of a fingernail or toenail from its nail bed). It can also cause yellowing and pitting of the nails. A subset of patients also have atopy (a history of atopic dermatitis, allergies/hay fever, and/or asthma), and it is unclear whether this represents an isolated disorder or a variant of eczema.

The exact etiology of nail dystrophy in hand eczema (HE) has not been fully understood, but it is suggested that eczema can adversely affect the nail matrix due to frequent periungual inflammation and lead to transient defects in the nail plate, causing Beau’s lines and pitting. As the nail unit is in constant contact with the environment, the nail apparatus is particularly vulnerable to eczematous involvement irrespective of the nature of the allergen or route by which it reaches the nail apparatus.

Nail dystrophy in hand eczema and correlation with severity index: A cross-sectional study - Indian Journal of Skin Allergy.

Nail involvement was seen in 76% of the patients; loss of cuticle was the commonest (37%) finding. A positive correlation (P = 0.012) was found between paronychia and nail dystrophic changes. Hand eczema severity index >12 was seen in 28.9% of patients with nail dystrophy as compared to 12.5% without nail dystrophy (P = 0.259).

Pompholyx eczema can affect the nail folds and skin around the nails

Pompholyx eczema, also known as dyshidrotic eczema, is a recurrent eczematous disorder of the hands and feet that can affect the nail folds and skin around the nails, resulting in swelling. This condition is commonly seen in older children and adults and is often associated with hyperhidrosis (excessive sweating). Patients with pompholyx eczema may have multiple small, intensely pruritic (itchy) vesicles on the palm of the hands, soles, or digits.

The nail folds can be severely affected by pompholyx eczema, with the cuticle being destroyed and a groove forming where the skin and nail meet. This can lead to pitting in the nails (dents that look like your nail was poked by an icepick), and onycholysis (loosening or separation of a fingernail or toenail from its nail bed).

The exact causes of pompholyx eczema are not known, but it can be triggered by a fungal skin infection, a reaction to something that has touched your skin, stress, or excessive sweating. It is important to treat nail eczema to avoid the worsening of the condition.

Pitting in the nails is a symptom of nail eczema

Nail changes are more common in hand eczema than toenail changes. Pompholyx eczema can affect the nail folds and skin around the nails (cuticles), resulting in swelling. Nail dystrophy in patients with atopic dermatitis and its association with disease severity is also a prevalence of finger or toe nail abnormalities. The prevalence of finger or toe nail abnormalities in hand or foot eczema was 15.7% (13/83; OR, 2.364; p=0.091) and that of patients without hand or foot eczema was 7.2% (11/152; OR, 0.236, p=0.091). Finger nail changes were seen in 9.1% (6/66; OR, 1.778; p=0.294) of hand eczema patients, and toe nail changes were seen in 20.0% (6/30; OR, 6.156; p=0.032) in foot eczema patients. There was no statistically significant difference in EASI scores according to types of nail abnormalities.

Onychorrhexis is the presence of longitudinal striations or ridging of the nails. Nail psoriasis and nail eczema are similar in that having eczema or psoriasis elsewhere on the body is usually a precursor. Both conditions can cause pitting in the nails, but nail psoriasis also causes lifting and white discoloration in the nails.

Nail dystrophy is more common in hand or foot eczema patients

Dyshidrotic eczema is a recurrent eczematous disorder of the hands and feet that is commonly seen in older children and adults. It is often seen in association with hyperhidrosis (excessive sweating). Patients have multiple small, intensely pruritic (itchy) vesicles on the palm of the hands, soles or digits. Maceration (softening and breaking down of the skin) and secondary infection are common due to severe pruritis (itching). Patients may also have nail problems, including onycholysis (loosening or separation of a fingernail or toenail from its nail bed), yellowing and pitting of the nails.

Hand eczema is common, and fingernail changes are more common than toenail changes. Pompholyx eczema can affect the nail folds and skin around the nails (cuticles), resulting in swelling. Nail eczema can cause pitting in the nails (dents that look like your nail was poked by an icepick), and requires treatment to avoid worsening of the condition.

Nail changes are more common in patients with hand or foot eczema. The inciting event causes complete cessation of nail matrix activity. Loss of the nail might or might not be permanent. Onychorrhexis (Fig. 3) is the presence of longitudinal striations or ridging of the nails.

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