White streaks
Non uniform white spots or lines on the nail are called leukonychia. They are usually the result of a minor trauma and are harmless in healthy individuals. Sometimes leukonychia is associated with poor health or nutritional deficiencies. Factors can include infectious, metabolic, or systemic diseases as well as certain drugs.
Nail Clubbing
Nail clubbing occurs when the tips of the fingers enlarge and the nails curve around the fingertips, usually over the course of years. Nail clubbing is sometimes the result of low oxygen in the blood and could be a sign of various types of lung disease. Clubbing may occur in cases of cirrhosis, cystic fibrosis, inflammatory bowel disease, congenital heart disease, liver disease and AIDS. Some cases of clubbed nails are hereditary.
Spoon nails
Spoon nails (koilonychia) are soft nails that look scooped out or concave. The depression usually is large enough to hold a drop of liquid. Often, spoon nails are a sign of iron deficiency anemia or a liver condition known as hemochromatosis, in which your body absorbs too much iron from the food you eat. Spoon nails can also be associated with heart disease and hypothyroidism.
Lifted nail plate
Onycholysis is the separation of a fingernail or toenail from its pink nail bed. The separation occurs gradually and is painless. The most common cause of onycholysis is trauma. Some medical conditions can cause onycholysis. These include fungal infections, psoriasis, exposure to some medications, overactive thyroid or iron deficiency
Thickened nails
This condition affects the toenails more than the fingernails. Older people are at greater risk. Causes include trauma, fungal infection, neglect, poor circulation, arthritis, and psoriasis
Horizontal lines/ridges
Beau’s lines are indentations that run across the nails. The indentations can appear when growth at the area under the cuticle is interrupted by injury or severe illness. Conditions associated with Beau’s lines include uncontrolled diabetes and peripheral vascular disease, as well as illnesses associated with a high fever, such as scarlet fever, measles, mumps and pneumonia. Beau’s lines can also be a sign of zinc deficiency.
Dark Vertical Lines
Dark lines beneath the nail should be investigated as soon as possible. They are sometimes caused by melanoma, the most dangerous type of skin cancer. Look for Hutchinson’s sign. This is when there is colour changes in the skin just before the nail starts. If this occurs you should get a biopsy of the nail bed. Other causes of the vertical lines could be injury, severe anaemia, infective endocarditis (inflammation of the inner tissue of the heart) and certain diseases such as rheumatoid arthritis. Vertical ridges in nail without colour can be a sign of ageing. This could also be racial melanonychia which is common in darker skinned individuals
Splitting nails
In this condition, the nail plate splits or layers as it grows off the nail bed. Common causes include constantly wet hands, especially while using soap and washing detergents, frequently using and removing nail polish, continuous mild trauma such as habitual finger-tapping or using the nails as tools, potentially thyroid disease or fungal nails
Inflammation of the skin alongside the nail – paronychia
The skin lying alongside the nail can become infected with bacteria, typically Staphylococcus aureus. This infection is called paronychia. Symptoms may include pain, redness and swelling around the cuticle and yellow-green discharge. It may be the result of lupus or another connective tissue disorder. Chronic paronychia (where the condition is present for a long time) is more difficult to treat. In chronic paronychia, the nail may distort and become discoloured, and the skin may lift at the site of infection. Sometimes, the inflammation spreads from one nail to another. A range of micro-organisms working together are responsible for chronic paronychia.
Fungal infection
Onychomycosis is a fungal infection of the toenails or fingernails that may involve any component of the nail unit, including the matrix, bed, or plate. The characteristics of a fungal nail infection depend on the cause, but may include lifting of the nail plate off the nail bed, thickening of the nail plate, crumbling of the nail plate, discolouration, white, yellow or green smelly discharge or flaking and pitting of the surface of the nail plate.
Ingrown toenail
One of the most common problems treated by podiatrists is ingrown toenails. The big toe is particularly prone to this painful condition. Causes may include incorrect nail-trimming technique, trauma, unusual nail shape or size, wearing tight shoes. Treatment from a podiatrist is usually quick and painless. But until the impacting nail is removed then the pain will not subside.
Pitted Nails
Nail pitting may show up as shallow or deep holes in your nails. Skin diseases such as psoriasis, eczema (dermatitis), alopecia, lichen planus or lupus can affect the nails. Other causes include connective tissue disorders and autoimmune diseases.
