Ms. Li, 53 years old, blisters and peeling on her feet a few years ago, some itching, at first she didn't pay much attention to it, often picked it with her hands, and then her toenails also began to thicken, white, yellow, and powdery scaling, at first only the big toe, and then other toenails also showed symptoms, so she paid attention to it and went to the hospital for treatment.
At the time of presentation, the doctor performed a microscopic examination of the nail skin and fungus, which showed spores and hyphae, and diagnosed onychomycosis with tinea pedis.
Subsequently, the doctor arranged for Ms. Li to have her liver function checked, and the results were normal, so she was given an oral antifungal drug itraconazole capsule, and an external drug sertaconazole nitrate cream and compound hibiscus skin tincture.
After several months of treatment, Ms. Li's toenails regained their luster, the diseased toenails gradually fell off, the nail dandruff fungus was negative for microscopic examination, and the symptoms of blister peeling on her feet also subsided and she recovered well.
The doctor reminds that onychomycosis, commonly known as "nail fungus", is contagious, not only to oneself, but also to family members, and if left untreated, it may cause bacterial infections of the lower limbs, such as paronychia, erysipelas and other skin problems. Onychomycosis is mainly due to the spread of fungal infection, so it must be treated in time when there is athlete's foot, and the treatment cycle of onychomycosis generally takes 3~4 months, and it must be cured by insisting on treatment.
Many people may not know that nails are actually a mirror of the body, a "barometer" of health, and their shape, color and texture may reflect the health of the body.
Today, we're going to talk about those "Morse codes" in your nails.
01
How do nails grow?
Nails are formed by the continuous division and differentiation of the nail matrix cells at the base of the nail to form keratinocytes, and then gradually form the nail plate of the nail, and finally form the nail.
Healthy nails are made up of the following main components:
- Nail matrix: The point at which the nail grows
- Nail Half Moon: Commonly known as "crescent", it is the part of the nail that has just grown
- Nail root: Nail under the skin
- Nail bed: The skin covered by the nails
- Deck: A nail that covers the skin
The growth rate of nails is generally affected by nutrition, environment, lifestyle habits, and disease factors, with normal fingernails growing 1 cm in about 3 months on average and toenails growing 1 cm every 9 months.
When the growing nail is too long and is cut off, the nail in the back will continue to move forward, which is the physiological process of normal nail growth.
However, some diseases, such as malnutrition or local trauma and fungal infections, can affect the normal growth of fingernails.
If the nail matrix is destroyed by a disease, the nail may not grow back, so when the nail growth is abnormal, it is necessary to go to the dermatology department in time for examination and symptomatic treatment.
02
Are all these rumors about nails true?
The appearance of nails is a reflection of physical health, but are all the rumors true? Not necessarily.
01
The less crescent moon on the hand, the worse the body?
No
The crescent is just a newly grown nail, and its size is related to the rate at which the nail grows, the faster the nail grows, the more pronounced the crescent will be.
When I was a child, my metabolism was fast, and my nails grew quickly, and most of my nails could see crescents.
In addition, due to individual physical differences, the size of the crescent moon is also different, and some people are born with a relatively small crescent, or even no crescent by birth.
02
Is nail leukoplakia due to calcium deficiency?
not necessarily
White spots on the nail may be caused by trauma to the root of the nail, if accidentally pinched or bumped, the new nail will not keratinize properly, and it will remain white and cannot become a transparent nail.
In addition, fungal infections on the nails may also cause white spots on the nails, accompanied by other symptoms such as thickening and deformation.
3
Is darkened nails cancer?
not necessarily
Nail discoloration is mostly caused by fungal infection, and it can also make the nail thicker, brittle, and easy to break, and can generally be cured after antifungal treatment under the guidance of a doctor.
It may also be a female nail nevus, which is a benign pigmented nevus that causes the nails to grow gray-black vertical lines that grow wider as they grow and develop, and the width will stabilize and no longer develop in adulthood.
Only rarely, a nail nevus becomes cancerous and becomes a malignant melanoma.
If the discoloration of melanoma is irregular, uneven in color, and rapidly expanding, it is necessary to seek medical attention promptly.
3
If these 4 abnormalities appear in the nails, be vigilant
01 clubbing
Clubbing finger is characterized by obvious widening and thickening of the terminal knuckles, arched and raised from the root to the end, and the basal angle formed by the skin on the back of the index finger and the nail is ≥ 180 degrees, and the normal obtuse angle is 160 degrees, of which the thumb is the most prominent.
Clubbing can be seen in a variety of diseases, mainly related to the presence of heart diseases, lung diseases, digestive system diseases, etc.
- Heart diseases: cyanotic congenital heart disease, rheumatic heart disease, pulmonary arteriovenous aneurysm, subacute infective endocarditis, etc., causing chronic hypoxia of tissues.
- Lung diseases: emphysema, idiopathic pulmonary fibrosis, chronic lung abscess, tuberculosis, bronchiectasis, lung cancer, etc., may cause hypoxia to persist and clubbing.
- Digestive system diseases: Crohn's disease, chronic ulcerative colitis, intestinal tuberculosis, amoebic dysentery, etc., may induce clubbing.
02 spoon fingers
The spoon-shaped finger, also known as the reverse nail, is characterized by the thinning of the nail, the middle of the nail is concave and spoon-like and the edge is upturned, the nail becomes brittle, easy to crack, the nail surface is relatively dry, and sometimes streaks appear.
Due to poor local blood circulation, nail nutrient deficiency and cysteine amount decrease, which in turn causes the nail bed to shrink and form anti-nails.
Spoon finger is more common in diseases such as iron deficiency anemia, high-altitude disease, hypothyroidism or coronary heart disease.
03 Bo's line
Boss's lines are the appearance of multiple horizontal streaks on the nail, often indicating malnutrition or a serious condition that temporarily affects nail growth.
In the presence of Bohn's lines, the nail may stop growing until the underlying condition is treated.
Most of the Beau's lines on the nails and toenails may be caused by measles, mumps, diabetes, thyroid disease, liver disease, cardiovascular disease, etc.
04Abnormal nail color
The normal nail color should be pink, and be vigilant if the nail color is abnormal.
- Pale nails: When the patient's red blood cell or hemoglobin content is lower than normal, the color of the nails will become pale, and it may also be accompanied by tiredness, fatigue, etc.; If the heart's pumping function is weakened, affecting blood circulation, the patient's nails may become cyanotic (purple and white).
- Yellowing of nails: It is mostly considered to be related to fungal infections, malnutrition and other factors.
- Blue nails: If the nail is traumatized, it can lead to bruising under the nails, which manifests as blue nails.
Blue nails can generally indicate severe hypoxia in patients with heart disease, that is, the blood oxygen content is low, the body does not supply enough oxygen, and the patient has asphyxia or systemic failure, resulting in congestion in the body.
Long-term chronic lung disease leads to a decrease in the concentration of blood oxygen in the blood, which can manifest as bluish connective tissue around the nails and bluish nails.
- Purple nails: It may be related to cardiovascular diseases, respiratory diseases, etc., such as congenital heart disease, or acquired rheumatic heart disease, mitral stenosis, etc., which can cause low hemoglobin oxygen content in the blood, so that the nails will turn purple.
In addition, if the patient's nail plate and nail bed are infected by fungi, it is also easy to cause changes in nail color, such as purple nails, stained color, and may also be accompanied by thickening, brittleness, red and swollen skin.
Bibliography:
[1] Yang Zhibo, Li Yuanwen, Xie Hongfu. Dermatology and venereology of traditional Chinese and Western medicine[M].Changsha. Hunan Science and Technology Press, 2020.
[2] Zhang Xuejun, Zheng Jie. Dermatology and Venereology. Beijing,People's Medical Publishing House,2018.189-190.
[3] Wang Chang. Practical Manual of Dermatology Diagnosis and Treatment 5th Edition[M].Zhengzhou. Henan Science and Technology Press.2018.605.
[4] Liu Wei, Li Qiang, ed., Practical diagnosis and treatment standards for dermatology in Air Force General Hospital[M].Zhengzhou, Henan Science and Technology Press, 2019.181
[5] Shi Yuxiu. Histology and Embryology. 3rd ed. Higher Education Press.2018.125.
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