Nail problems can be localised to the nails or as part of a general medical condition. Some nail conditions give a clue to the underlying medical problem. Skin rash that affects the skin can also affect the nails. Some nail problems include nail inflammation, benign and malignant skin growths, cyst and infection
The nails can be infected by virus, bacterial or fungus. Fungal nail infection is common and affects both finger and toe nails, leaving the nail plate brittle, thickened or completely destroyed. Virus can cause warts on the nail bed and the nail fold.
Treatment of nail infection
- Good hygiene and proper nail care
- Nail matrix biopsy
- Culture for bacteria and fungi
- Topical or oral antibiotic and antifungal
- Laser treatment
- Viral warts are treated by cryotherapy or laser or topical immunotherapy
Paronychia is an inflammation of the nail folds. Nail folds can be damaged by injury, habit biting or constant wet work. Bacteria and fungus will then infect the nail folds causing swelling and nail deformity.
Treatment of paronychia
- Keep the nail folds dry
- Avoid constant trauma like nail biting
- Treat secondary infection
Nails can be affected in psoriasis and the changes can be very varied. They can appear as pits on the nail bed, the nail plate may be separated from the nail bed (onycholysis) and the nails may be thickened and discoloured. Usually psoriasis is seen on the body or scalp
Treatment of nail psoriasis
- Nail biopsy to confirm psoriasis
- Topical or injection steroids
Melanonychia is seen as a brown line running along the length of the nails It can be seen in one or more nails. In Asians melanonychia is benign. It can look like melanoma, a skin cancer. Get an appointment with Dr Joyce Lim to confirm if it is melanonychia
Other nail problems include benign growths, myxoid cyst and skin cancers.