Nail dystrophy: Causes, Symptoms, Diagnosis, And Treatment.

What is Nail dystrophy?

Dystrophy of the nail, or onychodystrophy, is a change in the shape, size, and structure of the nail plate. It also includes changes to the nail bed and nail folds.

Onychodystrophy can be both an independent disease and a manifestation of pathologies of various body systems. Dystrophy of the nails can also be one of the manifestations of systemic disease.

With the same disease, different types of nail dystrophy can occur, and vice versa, one type of onychodystrophy can be observed in a wide variety of diseases.

In some cases, nail dystrophy precedes the development of clinical symptoms of a general or systemic disease. A competent dermatologist can note these symptoms and refer them to a specialized specialist for treatment at pre-symptomatic stages.

Some types of onychodystrophy indicate fungal infections of the nails. This is important to consider when making a differential diagnosis between fungal and non-fungal diseases. In all cases, microscopic examinations of scrapings from affected nails, subungual horny masses, cuticle particles are mandatory.

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Dystrophy of the nail plate

Every 5th person has pathologies of the nail plates. Most of these changes are symptoms of another disease, often extremely important for diagnosis. Dystrophies of the nails can indicate various dermatological diseases and diseases of the internal organs. The unaesthetic appearance of damaged nails causes significant psychological discomfort and affects the quality of life.

One of the main reasons for lifelong dystrophies of nails is improper cutting, filing, or even self-injury. The problem is especially acute in children because the consequences of improper nail care persist throughout their lives.

If a person has nail pathologies, it is not recommended to perform cosmetic procedures (manicure, pedicure, or plastic surgery) without first consulting a specialist, who will be diagnosed and, if necessary, prescribed treatment. So the patient has the opportunity not only to diagnose the already existing pathology of internal organs but also to stop the progression of the skin disease.

Often, dystrophy develops as a result of too frequent, unprofessional manicure and/or pedicure, or incorrect self-processing of nails. They negatively affect the condition of the nails: cleaning and polishing with excessive pressure on the matrix, excessive pushing back of the posterior nail roller, the constant presence of a coating (varnish, gel polish, shellac, etc.). The plates become thin and dull, transverse, sometimes longitudinal grooves appear.

The cosmetics themselves can also cause changes in nails, exacerbation of skin diseases of the hands and feet, and accelerate the spread of infection (if they are used on already damaged nails).

Nail Dystrophy Causes

What causes Nail dystrophy?

There are many reasons for the development of nail dystrophy. The most common:

• • Injury and damage.
  • Having eczema or psoriasis.
  • Fungal diseases.
  • Weakening of immunity, including due to prolonged infectious diseases.
  • The presence of endocrine disorders.
  • Lack of vitamins and minerals.
  • Violation of blood microcirculation.
  • Polluted environment: poor water quality. and polluted air.

Nail Dystrophy Symptoms

What are the Symptoms of Nail Dystrophy?

• • Changing the parameters of the nail plate (thinning / thickening).
  • Color change (fades, appears white / gray / brown tint).
  • The appearance of spots.
  • Deformation of nails: the appearance of dents, cracks.
  • The appearance of irregularities and "tracks" (longitudinal or transverse).
  • Detachment of the plate from the bed.

Features of the disease in children

They are often caused by lowered immunity, frequent chemical, traumatic effects. Longitudinal and transverse grooves on the nails can be a symptom of congenital pathology or skin disease.

The reasons for the development of nail dystrophy in children:

• • Non-compliance with personal hygiene, improper care.
  • Injuries.
  • Unbalanced diet.
  • History of infectious diseases.
  • Chronic diseases of internal organs.
  • Presence of psoriasis, dermatitis, or eczema.

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Features of the disease in adults

Changes in nails are very common, gender and age do not affect the possibility of developing these problems. The appearance of white spots, brittle nails, delamination - all these are manifestations of dystrophy.

The most common causes of nail dystrophy in adults are:

• • lack of vitamins and minerals.
  • injuries to the nail plates.
  • the presence of eczema or psoriasis.
  • fungal diseases.
  • weakened immunity against the background of frequent stress, overwork, prolonged infectious diseases.
  • endocrinological diseases.
  • cardiovascular diseases affecting circulatory disorders.
  • bad ecology.

Nail Dystrophy Diagnosis

How is Nail Dystrophy diagnosed?

The diagnosis is established by a dermatologist based on the results of a detailed history collection, analysis of clinical symptoms, and data from nail scrapings for mushrooms. For the purpose of pre-symptomatic diagnostics, a laboratory study of blood serum for the activity of alkaline phosphatase is carried out. For a more accurate diagnosis, additional research methods may be prescribed: dermatoscopy, confocal microscopy.

It is necessary to carry out the differential diagnosis of onychodystrophy with dermatomycosis, true pemphigus, Lever's pemphigoid, Dühring's dermatitis, epidermolysis bullosa, acrodermatitis, lichen planus, psoriasis, eczema, Deverji's disease, Darrieus dyskeratosis.

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Types of Nail Dystrophy

Dystrophies differ in the following ways:

By form

• • Concave (spoon-shaped). The reason is the thinning and softening of the nails. They occur with iron deficiency, infectious and chronic skin diseases, with systematic exposure to chemicals, prolonged use of decorative coatings, and liquids with a high acetone content.
  • By the type of "watch glasses". They can develop as a result of chronic diseases of the lungs and bronchi, osteochondrosis, neoplasms in the area of the nail bed.

By surface change

• • Pinpoint impressions, longitudinal and transverse grooves. They are observed in psoriasis, eczema, atopic dermatitis, when exposed to aggressive chemicals, when the nail and nail matrix are injured, blood microcirculation is disturbed, and in diseases of the gastrointestinal tract.

By thickness change

• • Thinning and delamination of nails. It occurs due to frequent contact with water, detergents. Thinning of the nail hole can occur when taking certain medications.
  • Thickening of the nail can be both a manifestation of chronic skin diseases (psoriasis, atopic dermatitis, etc.), and a symptom of fungal infections.

By color change

The presence of white spots, stripes, foci of yellowing, brown-black, blue, green, blue blotches. The color change is possible upon contact with dyes, the use of decorative varnishes, and a number of endogenous factors can also affect:

• • heart failure, iron deficiency, certain skin diseases;
  • long-term use of drugs, the presence in the diet of a large number of foods with a high content of carotene, carrots, tangerines, etc.).

Partial or complete peeling

These changes occur in some skin diseases (psoriasis, subungual warts, etc.) can occur as a result of trauma or fungal infection; due to taking medications, wearing narrow shoes. Peeling of the nail plates can occur with intolerance to the components of decorative coatings. Some drugs, such as vitamin A or tetracyclines, increase the photosensitivity of the skin, so they are not recommended to be taken during the period of solar activity, this can also lead to peeling of nails.

Onychodystrophies caused by external factors

Often, nail changes develop as a result of frequent polishing of the plate, excessive pressure of the tool on the nail matrix, excessive pushing back of the nail roller, constant application of decorative coatings. Nails become dull, thinned, brittle, transverse grooves appear.

Manicure and pedicure without the use of metal tools are considered the most gentle when special gels with keratolytic agents are applied or hardware techniques are used to soften and remove keratinized cuticle areas. Instead of decorative, protective and strengthening coatings for nails are used.

Dystrophy can develop with constant contact with detergents and fuels and lubricants. Injuries and compression lead to the occurrence of subungual hematomas, as a result, abnormalities of nail growth may appear, it may exfoliate from the nail bed, and a secondary infection, including fungal infections, may occur. Dystrophies of the nails of the toes often develop as a result of wearing narrow shoes, the nails become thinner or thicker, hemorrhages are possible, etc.

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Nail Dystrophy Treatment

How do you treat Nail Dystrophy?

The purpose of medical and preventive measures:

• • Elimination of the cause of the disease.
  • Improvement of blood microcirculation in the phalanges of the fingers.
  • Minimizing the risk of fungal infections.
  • Strengthening the nail plate.
  • Protection with creams.
  • use of gloves when working with chemicals.

Any change in the nail plates is a reason for consulting a dermatologist. The specialist will conduct an examination for the presence of concomitant diseases, establish the cause of the changes and, if necessary, prescribe treatment. Self-medication can lead to the progression of the underlying disease, which will entail longer therapy and additional consultations and examinations with specialized specialists.

In treatment, it is necessary to strictly follow the recommendations of the attending physician. The specialist will identify the cause that caused onychodystrophy and prescribe a comprehensive treatment aimed at eliminating it.

An important component of treatment is the restoration of the chemical composition of the nail. For this, vitamins and minerals are prescribed. Also recommended are drugs that improve blood microcirculation, angioprotectors, immunostimulating, fortifying agents.

In the treatment of nail pathologies associated with fungal infections, PUVA therapy has proven itself well. One of the types of light therapy, which uses UVA lamps, doctors use specially designed photosensitizers to enhance the therapeutic effect.

In difficult cases, corticosteroids, retinoids, quinolines, cytostatics are prescribed. The prognosis for the treatment of dystrophy of the nail plates is favorable. Nail changes lend themselves well to correction.

Massage

The main advantage of massage is its stimulating effect. This effect is achieved due to the huge number of important reflex centers that are located on the fingertips. Hand massage can be performed independently, morning is the most preferable time for it.

How the massage is performed: each finger is massaged separately in a circular motion, then the back of the hand is kneaded. Next, the hand is massaged along the entire length - from the hand to the shoulder. In conclusion, you need to clench and unclench your fists for several minutes, imitate playing the piano with your fingers.

Prevention of Nail Dystrophy

It is necessary to carefully care for the nails, monitor their condition and, if changes appear, contact a dermatologist. For manicure and pedicure, choose proven beauty clinics, where professional dermatologists-cosmetologists with a specialization in podology work. If possible, choose a gentle manicure without aggressive decorative coatings.

Do not neglect preventive visits to a dermatologist, the doctor will conduct an examination, advise additional preventive measures. Use protective equipment to protect your nails and skin during winter.

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