FUNGAL INFECTIONS (ONYCHOMYCOSIS)
When a nail infection develops, the most common cause is a fungus. More frequent on the toenails than on the fingernails, fungal nail infections affect about 12% of all Americans. Onychomycosis tends to run in families because of an inherited tendency, but not everyone is susceptible. It is rare in children unless one or both parents are infected.
The two most common types of fungi affecting the skin are dermatophytes and yeast (Candida). While both types infect nails, dermatophytes tend to be more common in toenails. Yeast infections are seen more frequently in fingernails. While some fungal nail infections may respond to topical antifungal creams, lotions, gels, and lacquers, most infections of the nail plate require oral medicines such as itraconazole, terbinafine, and fluconazole.
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BACTERIAL INFECTIONS
Redness, swelling, and pain of the skin folds around the nails often indicate an infection caused by bacteria. The most common cause of a bacterial infection is injury to the nail or surrounding skin. Frequent exposure to water and chemicals is a common cause of these bacterial infections. Sometimes a green discoloration of the nail occurs. A bacterium called pseudomonas causes this discoloration.
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TUMORS AND WARTS
These may be found in any portion of the nail and can cause the nail plate to change shape. When a growing tumor or wart interferes with nail growth, it can destroy the nail.
Warts are viral infections that affect the skin surrounding or underneath the nail. They can be painful and sometimes limit use of the affected finger or toe. Treatment usually involves destroying the wart with freezing or chemicals. If a wart or tumor extends into the nail folds or is located under the nail plate, surgery may be necessary to remove it.
Warts can be on the skin surrounding
the nail and underneath the nails.
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MUCINOUS CYSTS
Appearing as clear, jelly-filled papules at the base of the nail, these cysts can become painful and may damage or deform the nail. Treatment involves removing the cyst.
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DARK SPOTS OR STREAKS
If a dark spot or streak appears on any nail, and is not the result of an injury, it must be examined by a dermatologist. This could be melanoma, the most lethal form of skin cancer.
- Psoriasis can also affect the nails
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PSORIATIC NAILS
Psoriasis is a chronic skin condition that causes red, scaly patches. Approximately 10% to 50% of people with psoriasis, and 80% of people who suffer from psoriatic arthritis have nail problems, especially with their fingernails. The most common signs include pitting, rippling, and discoloration of the nail. With psoriatic nails, it is common
for the skin beneath the nail to develop a reddish-brown discoloration. Splinter hemorrhages can form. The nail may separate from the nail bed, crumble, and/or split. Swelling and redness of the skin surrounding the base of the nail also are common.
