Nails (Human Anatomy): Image, Functions, Diseases, and Treatments

Most primates have a plate at the very tip of their fingers and toes that resembles a claw. These plates are known as nails. Nails are similar to the claws found on other mammals. The powerful protective protein alpha-keratin, which is a polymer, is responsible for the strength of fingernails and toenails. The horns, hooves, and claws of vertebrates contain a lot of alpha-keratin.

The nail is made up of the nail plate, the nail matrix, the nail bed, and the nail grooves. The visible component of the nail is the nail plate.

A fingernail that is in good health serves the purpose of preventing injury to the distal phalanx, the fingertip, and the soft tissues that are located in the surrounding area.

Through the application of counter-pressure to the pulp of the finger, it also serves the purpose of improving the precise and sensitive movements of the distal fingers. In this way, the sensitivity of the fingertip is increased, despite the fact that the nail itself does not contain any nerve endings. The reason this happens is that when the tip of the finger meets something, the nail exerts a force in the opposite direction. In the end, the nail serves as a tool that enables a so-called 'extended precision grip' (for example, drawing a splinter out of one's finger) as well as specific cutting or scraping motions.

• Acral Lentiginous Melanoma: One type of illness is known as malignant lentiginous melanoma (ALM). Melanocytes, which are skin cells, can become cancerous, leading to the development of malignant melanoma, a kind of skin cancer. Acral lentiginous melanoma (ALM) or simply acral melanoma (palms, soles, fingers, toes, and nail units) is a kind of skin cancer that manifests on the hands and feet.
• Onycholysis: Onycholysis occurs when the nail lifts up from the nail bed. Nail injuries are a common cause, although fungus and other factors can also contribute to it.
• Paronychia: The most common cause of paronychia (nail infection) is bacteria. Cuticle and nail fold cuts allow bacteria to enter the skin (the skin around the nail). Typically, paronychia doesn't result in significant health issues. The infection can occasionally persist for a long time or recur after therapy.
• Pitting: Nail pitting can cause little or large holes in the nails. Both the toenails and the fingernails are susceptible to pitting. You can perceive the pitting as white patches or other imperfections. Your nails can even have the appearance of having been struck with an ice pick.
• Yellow Nail Syndrome: Yellow nail syndrome is a rare ailment characterised by slow-growing, hard, yellow, and dystrophic nails as well as lymphedema and respiratory tract disorders (YNS).
• Beau lines: The grooves in Beau's lines span the nails. Indentations may form when damage or severe disease prevents growth in the region below the cuticle.
• Onychogryphosis: Nail plate growth disorder onychogryphosis is characterised by elongation, increased curvature, and severe hyperkeratosis, as well as a blockage of the nail plate that is opaque and yellow-brown in colour It is often described as having a 'oyster-like' appearance or resembling a 'ram's horn nail.'
• Koilonychia: Spoon nails are soft nails that have a scooped-out look (koilonychia). The depression usually has enough space for a liquid drop. When your body absorbs excessive levels of iron from your diet due to a liver ailment called hemochromatosis or iron deficiency anemia, spoon nails are frequently a sign.
• Onychotillomania: Onychotillomania is a psychodermatosis caused by persistent self-inflicted damage to the nail unit. What makes it distinct is the compulsion and insatiable urge to pick at, pull out, or severely bite or injure the nail(s).
• Clubbing: Nail clubbing (Curved nails), which can occasionally be caused by low blood oxygen levels, can be a sign of a variety of various lung disorders. Nail clubbing has also been associated with AIDS, cardiovascular disease, liver disease, and inflammatory bowel disease.
• Blue Nails: Blue fingernails are frequently a symptom of chronic illnesses or low oxygen levels in red blood cells
• White Nails: Another term for white nails is leukonychia, which describes fingernails that are wholly or primarily white in colour. The white tint could be brought on by a number of things, including an accident, anaemia, nutritional deficits, heart or renal issues, or even poisoning.
• Pale Nails: pale nail indicates Anemia in the body.
• Half Pink, Half White Nails: This type of nail pattern indicates Kidney disease.
• Yellow Nails: indicates the Lung disease, nail infection
• Dusky Red Half-Moons On Nails: This type of pattern indicates that the patient could have lupus, heart disease, alopecia areata, arthritis, dermatomyositis.
• Blue Half-Moons: indicate that a person Could have suffered from poisoning.
• Nail Fungus: Fungus of the nail is a frequent infection that can affect the nail. It manifests itself initially as a white or yellow-brown patch directly beneath the cuticle of the affected fingernail or toenail. It is possible for the nail to darken, get thicker, and collapse at the edge as the fungal infection progresses deeper.
• Nail Psoriasis: Psoriasis of the nails is an autoimmune condition that can produce discolouration, pitting, and structural changes in the nails. It has the potential to make you feel self-conscious, but you can improve the appearance of your nails by buffing them and painting them with nail polish.
• Atopic Dermatitis: Atopic dermatitis, often known as eczema, is a disorder that manifests itself on the skin as dryness, itchiness, and inflammation. It is most frequent in infants and toddlers, but anyone of any age can develop it. Atopic dermatitis is a condition that lasts for a long period (chronic) and has a tendency to flare up sometimes. Although it may be annoying, it does not spread to other people.
• Brittle Nail Syndrome: The increased fragility of the nail plate that results from brittle nail syndrome manifests itself clinically as cracking, peeling, and friability of the nail. Up to twenty percent of the general population is affected by this illness, which manifests nearly entirely in the fingernails.
• Idiopathic Brittle Nails: Under an electron microscope, brittle nails are identifiable by the disorganisation of keratin filaments, as well as the protein and lipid structures. The formation of disulfide bonds between cysteine residues in keratin filaments enables adhesion between corneocytes and contributes to the tenacity of the nail.
• Secondary Brittle Nails: Brittle nail syndrome can be caused by a variety of factors, including dermatological conditions, nutritional deficits, and drugs. Psoriasis, lichen planus, Darier's disease, and eczema are some of the dermatological disorders that are associated with this syndrome.
• Myxoid Cysts: On the dorsum of the finger, translucent, dome-shaped lumps called myxoid cysts form. On the toes, these cysts can occasionally form in a location similar to that.

• Capillary Nail Refill Test: A simple examination is performed on the nail beds called the capillary nail refill test. Dehydration and the amount of blood flowing to tissue are both monitored using it.
• General Examination: It includes checking the nail condition by physician properly by looking on them and scrapping off them. Mostly nail condition could be identified by general examination.
• NAPSI: A quantitative, repeatable, objective, and simple method for determining the severity of nail psoriasis is the Nail Psoriasis Severity Index (NAPSI). This scale is designed to evaluate the severity of nail matrix and nail bed psoriasis according to the location of the nail unit that is affected.
• Nail Biopsy: The nail biopsy (NB) procedure can be used to identify a clinically ambiguous nail condition that cannot be identified by a patient's medical history, clinical appearance, or conventional mycology.

• Self care: Many cases of nail fungus could be treated with self care which includes trimming of nails properly, cleaning it on a regular basis, applying moisturizer.
• Matricectomy: The nail matrix, a germinative epithelium, creates the nail plate by repeatedly differentiating its basal cells. Matricectomy is the surgical, chemical, or electromagnetic means of removing or destroying the nail matrix. When the viable nail matrix is fully eliminated, the nail plate is lost. Therefore, a fresh nail plate cannot be renewed.
• Injections: This entails having injections straight into or close to your psoriatic nails. You might receive a second treatment in a few months if the first one yields subpar results. Injections of corticosteroids can be used to treat nail overgrowth, ridges, thickness, and separation of the nails from the fingers or toes.
• Laser Treatment: Comparative to other treatment techniques, the use of new laser technologies in the management of onychomycosis has tremendous promise for eradicating clinical manifestations of dermatophytic nail infection.
• Warm Compression: soaking the nail in warm water 3 to 4 times each day.
• PUVA: Psoralen must first be soaked in (or taken) before doing this. You are then cautiously exposed to UVA radiation. Nails that are splitting apart from fingers or toes and those that are discolored may both respond well to PUVA treatment. It is ineffective in treating nail pitting.
• Surgical Incision And Drainage: An easy paronychia or eponychia doesn't need to be incised on the skin. Typically, the eponychium can be fixed by simply removing it from the nail plate where it is most bothersome or fluctuating. At the location of the greatest variance, insert the tip of a scalpel blade (or an 18 gauge needle) under the paronychia or eponychia.
• Partial Nail Avulsion: A doctor trims a portion of the toenail to prevent it from piercing the skin. This procedure is also known as a partial nail avulsion.

• Oral Antifungal Medicines: Many times, antifungal medications such as itraconazole, terbinafine, and fluconazole are prescribed initially. These medications accelerate the growth of a new nail that is free of infection, which gradually replaces the affected portion of the nail.
• Antifungal Medicated Nail Creams: creams, such as efinaconazole and tavaborole, are often given by the dermatologist to treat fungal infections of the nails. After soaking, use this product directly into the diseased areas of the nails.
• Medicated Nail Polish: An antifungal nail lacquer called ciclopirox is used to treat nail infections. Once every day, you are supposed to apply it on your diseased nails as well as the skin around them.
• Corticosteroids: The most frequent corticosteroids used to treat nail psoriasis are clobetasol propionate and betamethasone dipropionate. Corticosteroids are the most effective medications for treating nail psoriasis.
• Tazarotene: Tazarotene is a therapy that has the potential to be very beneficial for treating pitting, a splitting nail, and discolouration.