Noah Sinclair
Nail dystrophy is a disorder that affects the texture or composition of the nail. It can be caused by a number of factors, including fungal infections, trauma, congenital abnormalities, psoriasis, lichen planus, benign tumours, and occasionally cancer. Nail dystrophy can manifest in a number of ways, including thickening, ridging, onycholysis, pterygium, or complete nail loss.
| Characteristics | Values |
|---|---|
| Definition | Dystrophies are changes in nail texture or composition |
| Causes | Nail injuries, birth deformities of the nails, psoriasis, lichen planus, benign tumours, fungal infections, cancer, trauma, chronic manipulation, nail biting, grooming, and inflammation |
| Symptoms | Thickening, ridging, onycholysis, pterygium, complete nail loss, periungual telangiectasias, leukonychia (transverse white lines), central longitudinal ridging, yellowing, pitting, increased friability, roughened texture |
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What You'll Learn
Nail dystrophy is often caused by a fungal infection
Nail dystrophy is a disorder that affects the texture and composition of the nail. It is often caused by a fungal infection (onychomycosis), which accounts for about 50% of cases. The infection causes distortion and discolouration of the nail plate structure, with symptoms including thickening, ridging, onycholysis, pterygium, or complete nail loss.
Nail dystrophy can also be caused by repeated trauma to the cuticle, such as nail biting, grooming, and chronic manipulation. This can lead to leukonychia, which presents as transverse white lines on the nail. Constant picking of the nail plate can cause median nail dystrophy, resulting in central longitudinal ridging.
In children, a disorder known as twenty-nail dystrophy (trachyonychia) can occur, characterised by yellowing, pitting, increased friability, and other dystrophic changes. This disorder typically affects otherwise healthy school-aged children and progresses over several months, eventually involving most or all of the nails and giving them a roughened texture.
Nail dystrophy can also be caused by congenital abnormalities, psoriasis, lichen planus, and occasionally tumours, both benign and malignant.
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Nail biting, grooming and chronic manipulation can cause nail dystrophy
Nail dystrophy is a distortion and discolouration of the normal nail plate structure. It can be caused by any traumatic or inflammatory process that involves the nail matrix. Nail biting, grooming and chronic manipulation can all cause nail dystrophy. Repeated trauma to the cuticle may produce leukonychia (transverse white lines) and constant picking of the nail plate leads to median nail dystrophy (central longitudinal ridging). Twenty-nail dystrophy (trachyonychia) is a disorder of otherwise healthy children of school age and is characterised by yellowing, pitting, increased friability, and other dystrophic changes that progress over several months to involve most or all of the nails, giving them a roughened texture.
Nail dystrophy can also be caused by a fungal infection (onychomycosis), which accounts for about 50% of cases. The remainder result from various causes, including nail injuries, birth deformities of the nails, psoriasis, lichen planus, and occasionally tumours (cancerous and noncancerous). Drugs, infections, and diseases can cause discolouration of the nails (chromonychia). For example, infection with Pseudomonas bacteria can cause a greenish discolouration (see Green Nail Syndrome).
Median nail dystrophy (dystrophia unguium mediana canaliformis) is an uncommon temporary nail disorder in which a split or canal-like dystrophy develops in one or more nails, usually those of the thumb. From: *Hurwitz Clinical Pediatric Dermatology (Fourth Edition)*, 2011.
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Nail dystrophy can be caused by trauma to the cuticle
Nail dystrophy is a distortion and discolouration of the normal nail plate structure. It can be caused by trauma to the cuticle, such as nail biting, grooming, and chronic manipulation. Repeated trauma to the cuticle may produce leukonychia (transverse white lines) and constant picking of the nail plate leads to median nail dystrophy (central longitudinal ridging). Twenty-nail dystrophy (trachyonychia) is a disorder of otherwise healthy children of school age and is characterised by yellowing, pitting, increased friability, and other dystrophic changes that progress over several months to involve most or all of the nails, giving them a roughened texture.
Nail dystrophies can also be caused by fungal infections (onychomycosis), which account for about 50% of cases. The remainder result from various causes, including nail injuries, birth deformities of the nails, psoriasis, lichen planus, and occasionally tumours (cancerous and noncancerous). Drugs, infections, and diseases can cause discolouration of the nails (chromonychia). For example, infection with Pseudomonas bacteria can cause a greenish discolouration (see Green Nail Syndrome).
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Tumours (cancerous and noncancerous) can cause nail dystrophy
Nail dystrophy is a distortion and discolouration of the normal nail plate structure. It can be caused by any traumatic or inflammatory process that involves the nail matrix. Nail dystrophy can be caused by nail biting, grooming, and chronic manipulation. It can also be caused by tumours, both cancerous and noncancerous.
Tumours can cause nail dystrophy by putting pressure on the nail bed, which can lead to changes in the nail's texture, shape, and composition. This can result in thickening, ridging, onycholysis, pterygium, or even complete nail loss. The changes can affect single or multiple nails and often correlate with the duration of the disease.
Nail dystrophy caused by tumours can be diagnosed through a physical examination of the nails, as well as through histopathologic examination and periodic acid-Schiff (PAS) examination, culture, or polymerase chain reaction (PCR) analysis. Treatment options for nail dystrophy caused by tumours may include surgical removal of the tumour, chemotherapy, or radiation therapy, depending on the specific type and location of the tumour.
It is important to note that nail dystrophy can also be caused by other factors, such as fungal infections, nail injuries, birth deformities, psoriasis, lichen planus, and certain drugs, infections, and diseases. Therefore, a thorough medical evaluation is necessary to determine the underlying cause and develop an appropriate treatment plan.
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Nail dystrophy can be a symptom of cGVHD
Nail dystrophy is a distortion and discoloration of the normal nail plate structure. It can be caused by any traumatic or inflammatory process that involves the nail matrix, including nail biting, grooming, and chronic manipulation of any sort. Nail dystrophy can also be caused by a fungal infection, which accounts for about 50% of cases. Other causes include nail injuries, birth deformities of the nails, psoriasis, lichen planus, and occasionally tumours (both cancerous and noncancerous).
Nail dystrophy can be a symptom of chronic graft-versus-host disease (cGVHD). cGVHD is a common complication of stem cell or bone marrow transplants, in which the donated cells attack the recipient's body. Nail dystrophy in cGVHD can present as thickening, ridging, onycholysis, pterygium, or complete nail loss. These changes can affect single or multiple nails and often correlate with the duration of the disease.
The treatment of nail dystrophy in cGVHD focuses on managing the underlying condition and minimising the impact on the patient's quality of life. This may include medications to suppress the immune system, such as corticosteroids, or other immunosuppressive agents. In some cases, nail dystrophy may resolve on its own over time, especially if the cause is related to trauma or inflammation.
It is important to note that nail dystrophy can also be a symptom of other conditions, and its presence does not necessarily indicate cGVHD. A thorough medical evaluation is necessary to determine the underlying cause and develop an appropriate treatment plan. Early diagnosis and management of nail dystrophy can help improve patient outcomes and reduce the impact on nail health and appearance.
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Frequently asked questions
Nail dystrophy is a distortion and discolouration of the normal nail plate structure. It is a change in nail texture or composition.
Nail dystrophy can be caused by a number of factors, including fungal infections, trauma, congenital abnormalities, psoriasis, lichen planus, benign tumours, and occasionally cancer. Nail biting, grooming, and chronic manipulation can also lead to nail dystrophy.
Symptoms of nail dystrophy include thickening, ridging, onycholysis, pterygium, and complete nail loss. It can also cause leukonychia (transverse white lines) and central longitudinal ridging.
