{"id":1135,"date":"2023-01-07T00:58:28","date_gmt":"2023-01-07T05:58:28","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/?post_type=chapter&p=1135"},"modified":"2023-01-17T14:00:03","modified_gmt":"2023-01-17T19:00:03","slug":"nails","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/chapter\/nails\/","title":{"raw":"Nails","rendered":"Nails"},"content":{"raw":"In addition to <\/span>disorders that primarily affect the nails, abnormalities in the nail may be markers of systemic conditions<\/span> and overall health status<\/span>. <\/span>They can also provide useful clues towards certain skin conditions when the appearance of the rash <\/span>is not diagnostic.<\/span>\u00a0<\/span><\/span>\u00a0<\/span>\r\n\r\n \r\n\r\nHover over image for caption.<\/strong><\/em>\r\n\r\n[h5p id=\"162\"]\r\n\r\n \r\n
\r\n\r\nTerminology for nail findings and their clinical significance:\r\n\r\n[table id=14 \/]\r\n\r\n<\/div>\r\n
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In addition to <\/span>disorders that primarily affect the nails, abnormalities in the nail may be markers of systemic conditions<\/span> and overall health status<\/span>. <\/span>They can also provide useful clues towards certain skin conditions when the appearance of the rash <\/span>is not diagnostic.<\/span>\u00a0<\/span><\/span>\u00a0<\/span><\/p>\n

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Hover over image for caption.<\/strong><\/em><\/p>\n

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Terminology for nail findings and their clinical significance:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
<\/td>\nDescription<\/strong><\/td>\nClinical Significance\u00a0<\/strong><\/td>\n<\/tr>\n
Onycholysis<\/strong><\/td>\nDistal nail plate detaches from nail bed causing white appearance distally<\/td>\nPsoriasis and onychomycosis most common; trauma, drugs (commonly tetracyclines), tumors under nailbed\u00a0<\/td>\n<\/tr>\n
Beau\u2019s lines\u00a0<\/strong><\/td>\nTransverse depressions of the nail plate\u00a0<\/td>\nMost often trauma; eczema around nail; involvement of multiple digits at same level suggests systemic cause\u00a0<\/td>\n<\/tr>\n
Onychomadesis<\/strong><\/td>\nDetachment of nail plate from proximal nail fold (a depressed groove replaces proximal nail plate)\u00a0<\/td>\nSingle nail \u2013 most often trauma\u00a0
\nMultiple \u2013 systemic cause such as HFMD<\/td>\n<\/tr>\n
Trachyonychia<\/strong><\/td>\nDiffuse homogenous roughness, loss of translucency\u00a0<\/td>\nIsolated finding\u00a0
\nAlopecia areata, lichen planus, psoriasis, eczema<\/td>\n<\/tr>\n
Pitting\u00a0<\/strong><\/td>\nPunctate depressions of nail plate surface\u00a0<\/td>\nPsoriasis, alopecia areata, eczema\u00a0<\/td>\n<\/tr>\n
Splinter hemorrhages\u00a0<\/strong><\/td>\nRed to purple thin longitudinal lines in the nail plate\u00a0<\/td>\nTrauma (most common), psoriasis, onychomycosis; proximal splinters are rare and suggest systemic disease (e.g. endocarditis, vasculitis)\u00a0<\/td>\n<\/tr>\n
Longitudinal melanonychia\u00a0<\/strong><\/td>\nLongitudinal brown to black band(s)\u00a0<\/td>\nMultiple: physiologic, trauma, drugs, systemic cause\u00a0
\nSingle: nevus, melanoma<\/td>\n<\/tr>\n
Subungual hyperkeratosis\u00a0<\/strong><\/td>\nThickened nail due to build-up of scale under the nail plate<\/td>\nOnychomycosis, psoriasis, eczema\u00a0<\/td>\n<\/tr>\n
Koilonychia<\/strong><\/td>\nSpoon-shaped nails\u00a0<\/td>\nNormal in 2nd-4th toes in children aged 1-4 years; Adults: severe iron deficiency\u00a0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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