Nail Diseases

Nail Diseases can occur alone or are associated with other skin conditions.

Common diseases of the nails include:

• Nail infection by bacteria, fungi and yeast.
• Paronychia - an infection of the nail fold. Nail fold infection usually results from injury to nail fold. Causes of injury include habit biting and constant wet work. People whose hands are exposed to water most of the time, e.g. housewives, canteen operators, cooks are more prone to develop paronychia.
• Nail disorder due to skin disease e.g Psoriasis
• Nail injury

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

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

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

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

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

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 may be used. Treatment may last several months depending on the type of infection and the oral medication.

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.

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.

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.