A patient who comes to see him should not only be asked in detail about his complaints. Every doctor knows the importance of examining a patient, including the condition of his skin. A lot of additional information can be obtained if onychopathy is present, which becomes a reflection of internal diseases, even if these diseases have not yet manifested specific symptoms. The color of the patient's nails is especially informative for the doctor, since its change is difficult to hide. Timely diagnosis of hidden diseases allows you to start effective treatment.

Deformation of the nail plates often becomes  one of the symptoms  of diseases of the internal organs, and this fact is important in making a general diagnosis. By some changes in the color of the nails, many serious diseases can be suspected and, by prescribing an additional examination, they can be detected at an early stage of development.

Nail discoloration varies from white to light yellow and – by stages of darkening – orange and brown - to red, and even, it happens, to blue, green and black. The color of the nails can change both on the entire nail plate and on its part, and even look like a kind of pattern on it.

Nail discoloration options and comorbidities 

Leukonychia  – one of the common types of nail pigmentation disorders, mainly affecting the fingernails. With leukonychia, in the thickness of the nail plate, you can see white areas of different sizes and shapes: in the form of small white dots or transverse stripes. Sometimes the entire nail plate may turn white, sometimes – only part of it, and sometimes there can be dots and stripes on the nail at the same time. Leukonychia occurs & nbsp; usually after serious illnesses, especially infectious ones, as well as after neuritis or serious poisoning.

Murke Lines – two white stripes on the nail, which are parallel to the hole and do not move as it grows. This color of the nails usually becomes a sign of hypoalbuminemia, appears with nephrotic syndrome; if the serum albumin level is normalized, the stripes on the nails disappear.

Terry's symptom – characterized by a two-color nail: two-thirds of the color of the nail is white, the distal third of the nail  – pink. The symptom is typical for patients with  heart failure and liver cirrhosis, which is accompanied by hypoalbuminemia.

Sometimes the distal half of the nail is brown and sharply separated from the pure white proximal part. In this case, the nail hole is not visible, the symptom is typical for patients with uremia.

Hyperpigmentation is a change in the color of the nails due to the accumulation of melanin and other pigments. The color of the nails may change throughout the plate, in parts of it, or appear as spots and stripes.

Brown color of nails is typical for patients with primary adrenal insufficiency, hemochromatosis. A single dark streak on the nail often turns out to be a pigmented nevus, and if such a streak captures the posterior nail fold, the doctor should suspect melanoma. In addition, with subungual melanoma, the posterior and lateral nail folds, matrix, nail bed, and the entire nail plate can become black-brown. The hole is not visible, and the nail is gradually destroyed.

A fungal infection changes the color of the nails to dirty gray, and with some trichophytosis – to yellow or ocher yellow. Some fungi can stain the nail plate black, dark gray and brown. If  the nail is infected with Pseudomonas aeruginosa, it may have a green color.

Yellow Nail Syndrome – in addition to degeneration of the nail plates and staining them yellow, it signals pathologies of the lymphatic system in combination with diseases of the internal organs (most often there may be respiratory diseases or malignant neoplasms).

Drug pigmentation of nails – happens when the body is exposed to certain drugs and is quite common. Tetracycline antibiotics can cause brownish nail color, phenolphthalein preparations cause bluish or blue stripes on the nail bed in combination with dark blue pigmentation in the area of ​​the holes. Silver preparations cause a bluish-gray coloration of the nail bed, and resorcinol causes an orange-red color of the nails.

Sometimes nails can be permanently stained if the patient uses poor quality nail polish.

Longitudinal subungual hemorrhages – look like many thin stripes of red or brown. If the center of the nail is affected – the cause may be infective endocarditis if the distal – this is most likely the result of a nail injury.

Treatment of onychopathy associated with discoloration of the nail 

Changed nail color – it is, first of all, a symptom of an internal disease or external influence, and therefore therapy is reduced to the elimination of a provoking factor. For the treatment of onychopathy, ointments and nourishing oils are used, if necessary – antifungal agents, and in case of infection – antibacterial drugs.

Thus, the most important task of the doctor is to identify onychopathy at an early stage and refer patients who have changed the color of the nails for consultation with related specialists, since in many cases the changed color of the nails becomes the first sign of a systemic pathology.

Add a comment