Nail Atlas: A Clinical Approach

by KJPS Puri

Healthy nails are pink, lustrous, strong and flexible. Such nails are considered sign of good health. Today it is a basic instinct of every human, not only to have flawless skin and well groomed hair but also to have pink lustrous healthy nails. Unhealthy and deformed nails not only reflect the underlying disease but also have a significant physical and mental impact on patient’s health. Now with such background, it has become mandatory to know the cause of nail changes. In fact these nail changes may provide us with subtle and obvious clue to the diagnosis of underlying disease, sometime interestingly well before the clinical presentation of the disease. Nail disorder comprises approximately 10% of all dermatological condition. Any portion of the nail unit may get affected by various dermatological condition, systemic disease, infections, aging process, internal and external medication, vascular insufficiency, physical and environmental agents, trauma, neurological abnormalities, nutritional deficiency and both benign and malignant tumor. Various nail abnormalities result in pain or interference with functioning or both. Nail disorder may affect walking, picking up of fine objects and protective function. Functional defect may cause problem in wearing shoes. In many societies the aesthetic aspects of the nail unit may affect occupation, employability and interaction with other people. The increasing emphasis on the aesthetic consideration in dermatology means even the slightest nail change may assume significance for the patient. Abnormal nails are of utmost clinical importance, especially when they are the only presenting feature without any other apparent signs and symptom of a disease. Hence nail provides us insight of window looking through which one can establish the diagnosis.

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