The nail plate must be even, light, uniform, without dots, spots and stripes. When change in the external state of the nail we are talking about onychodystrophy.
There are several types of such lesions of the nail, which are classified depending on the shape of the nail, the cause and external changes.
There is such a rare disease of the nail plate as onychogryphosis.
With this pathology, the periungual tissue changes, the horny plate hypertrophies, thickens and twists .
As a result, the nail looks and shaped like the claw of a griffin - a mythical bird.
Let's take a closer look at estet-portal.com causes, symptoms and treatments for onychogryphosis.
- What factors initiate the development of onychogryphosis
- Mechanism of development of onychogryphosis when wearing tight and uncomfortable shoes
- Stages of development and main symptoms of onychogryphosis
- What are the treatments for onychogryphosise
What factors initiate the development of onychogryphosis
The term "onychogryphosis" was introduced into practical dermatology by the physiologist and physician R. Virchow.
Onychogryphosis often affects older people, but in some cases the disease can develop even in children. There are also cases of diagnosing onychogryphosis in athletes.
The process is associated with syphilitic or mycotic etiology.
Factors that are triggers for onychogryphosis:
- frostbite;
- injuries, impaired blood supply of the local nature of the periungual tissues;
- tight and uncomfortable shoes;
- incomplete or poor-quality processing of nail plates;
- local infectious processes on the skin;
- Anhidrosis;
- metabolic changes in the dermis;
- physiological skin aging;
- varicose veins, keratoses and chronic dermatoses;
- skin sensitization and immune disorders.
In medicine, cases of congenital onychogryphosis are described, the cause of which is unidentified gene mutations.
The mechanism of development of onychogryphosis has not been fully determined, however, it is known that the only exact factor in the development is malnutrition of the nail plateny.
Varieties and main causes of onychodystrophies
The mechanism of development of onychogryphosis when wearing tight and uncomfortable shoes
If there is subungual hematoma in onychogryphosis, it can be concluded that the cause is wearing tight shoes, frostbite or nail injury.
Hematoma compresses the tissues around the nail, disrupts their nutrition and contributes to the development of disorders in the matrix of the nail plate.
Intracellular retention of exudate provokes thickening of horny cells with metabolic disturbances in them.
Keratinocytes, when damaged, release pro-inflammatory cytokines that cause an inflammatory process in the dermis.
T-lymphocytes secrete interleukin, which increases the proliferative and exudative processes in the nail matrix and surrounding tissues.
Corn cells with such a change in composition and as a result of swelling begin to intensively divide.
Layers of horny cells grow, overtaking each other, while keratinocytes are layered, changing the nail plate, its color and shape.
Hyperkeratosis is formed, which breaks the connection of the nail with its bed.
Over time, nail hypertrophy appears, which in shape resembles a vulture clawon.
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Development stages and main symptoms of onychogryphosis
In dermatological practice, it is important to distinguish between acquired and congenital onychogryphosis, as therapy depends on the cause of the process.
Clinically, there are 2 stages of development of the process:
1. Early stage.
Pain in the soft tissues under and around the nail plate, which is aggravated by walking.
More often the process covers the big toe. Pain increases with any pressure on the nail.
After some time, the nail thickens and rises above the level of the nail bed.
When the thickness of the nail is more than 1 mm, the process can be called onychogryphosis. Such a nail changes its color and cannot be trimmed without pretreatment and softening.
2. Second Stage.
Longitudinal and transverse stripes appear on the nail plate.
The stratum corneum of the nail becomes twisted and becomes very hard. The color of the nail becomes dirty yellow with a gray tint.
At this stage, wearing any kind of footwear provokes severe pain.
The nail may curl inwards, and become like a bird's beak. The direction of the nail can be spiral or helical.
Patients are unable to put on shoes without assistance, and walking becomes very painful and problematic.
It is not difficult to diagnose onychogryphosis, given the characteristic appearance of the nail with it.
If onychogryphosis is acquired, it is necessary to take a blood sample to determine RW, as well as to determine the level of sugar in the blood, since onychogryphosis is characteristic of diabetes and syphilis at a late stage.
It is also necessary to exclude mycotic infection.
For this purpose, I use a Wood's lamp, inoculate the material on nutrient media, conduct dermoscopy, and also study scraping from the affected leg under a microscope.
You will also be interested in the article: Modern aspects of diagnosis and treatment of onychomycosis
What are the treatments for onychogryphosis
The goal of therapy for onychogryphosis is to reduce the thickness of the nail plate and return the nail to its normal shape.
To achieve this result, it is necessary to completely or partially remove the nail plate.
In a conservative approach, the nail is softened with a special paste, which must be applied to the affected nail for 30-40 minutes.
Then the paste is washed off with warm water, and the softened part of the nail is removed mechanically.
It will take several of these courses to be effective. It is advisable to simultaneously appointment of local ointments based on gelatin and retinol, as well as oral intake of vitamins for a course of up to several months.
An alternative is keratolytic patches.
In extremely severe cases, removal of the nail plate by surgery or laser.
If the fingernail is affected, the base is retained for aesthetic purposes. Unfortunately, a complete cure for onychogryphosis is almost impossible.
Nail Deformity: Cause, Diagnosis and Treatment
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