What a nail disorder is that

Nail changesPossible causesBeau lines (Synonym: Beau-Reil transverse furrows) Transverse grooves of the nails (ICD-10: L60.4)Any serious illness affecting nail growth, Raynaud's disease, pemphigus, infectious diseases, intoxications, traumatic injuries; become visible about two to three months after the diseaseDoilichonychia - long and narrow nailsMarfan's SyndromeYellow fingernail syndrome (Yellow nail syndrome) yellowish discolored nails (ICD-10: L60.5)chronic bronchitis / chronic cough, chronic respiratory diseases, bronchiectasis, immunodeficiency, lymphedema, Raynaud's disease, nephrotic syndrome, pleural effusion (pathological increase in fluid between the leaves of the pleura, rheumatoid arthritis, thyroiditis (inflammation of the thyroid), tuberculosis.
Yellowish discolored nails are also common in smokers, but this cannot be assigned to the yellow nail syndromeGreen Nail Syndrome (Synonyms: chloronychia; green nail; English green nail syndrome)The color of the nail can vary as follows: yellowish-green, green, green-violet or green-blackish; Fingernails are more likely to get sick than toenails; the thumb and big toenails are most frequently affected; The cause is an infection with the Pseudomonas aeruginosa germ, which is usually caused by pre-existing nail damage, such as mechanical stimuli and / or a damp environment.Half-and-half-nails - half brownish red, half white discolored nailsSpecific for renal insufficiencySky blue lunula - normally skin-free, whitish translucent base of the nail bedWilson's disease (copper storage disease)
Silver poisoningKoilonychia (spoon nails)- Nail changes with trough-shaped depression and increased fragility of the nail plateIron deficiency anemia (anemia due to iron deficiency), hemochromatosis (iron storage disease), Raynaud's disease, Plummer-Vinson syndrome, systemic lupus erythematosus (SLE), traumatic injuriesLongitudinal stripes or groovesUsually occur in the aging process. But it can also be an expression of alopecia areata, vitiligo (white spot disease), atopic eczema (neurodermatitis) or psoriasisLeukonychia (white nails: point, line or patch-shaped white areas of the nails)Inflammatory kidney and intestinal diseases, diabetes mellitus, circulatory disorders, heart failure (heart failure), hyperthyroidism (overactive thyroid), liver failure, liver cirrhosis, Hodgkin's disease, nephrotic syndrome, lack of vital substances (micronutrients) [1, 2, 3]Lindsy nails- proximally white, distal pink-reddish-brown, cannot be printed awaychronic kidney disease with azotemia (abnormal increase in the nitrogenous end products of protein metabolism in the blood)Mees stripes (transverse leukonychia)- white horizontal stripesSmall injuries to the nail, e.g. B. in cosmetic treatments, heart failure (heart failure), malaria, Hodgkin's disease, leprosy
Arsenic, thallium and carbon monoxide poisoning
Melanonychia striata longitudinalis -Longitudinal, stripe-shaped light brown or black nail pigmentation

Normal variant in dark races, occurs in more than 70% of the black population over the age of 20.

Melanocytic causes are:

  • Melanocytic nevus of the nail root or nail bed
  • Malignant melanoma of the nail root or nail bed
  • Laugier-Hunziker syndrome

There are also exogenous (drugs) and microbiological causes (fungal colonization; bacteria).

Clinical evidence of the possibleDevelopment of a malignant melanoma in melanonychia striata longitudinalis:

  • sudden appearance in previously inconspicuous nail plate
  • particularly suspicious on the thumb, index finger or big toe
  • additional signs of nail dystrophy
  • positive Hutchinson’s sign, d. H. Longitudinal nail pigmentation with periungual pigmentation / the discoloration spreading to the nail wall
  • Age: mostly> 60 years

Note: In childhood, the prognosis of melanonychia striata longitudinalis is different from that in adulthood.

Muehrcke lines - white linesthat extend over the entire nail and disappear when pressure is applied to the nailOccur in up to 60% of cases with chronic kidney disease; specific for hypoalbuminemia (decreased blood albumin level: <2.2 g / dL)

Onycholysis - Detachment of the nail from the nail bed (ICD-10: L60.1)
 Traumatic injury,  Amyloidosis, atypical hand, foot and mouth disease (HFMK), chronic infections, hyperthyroidism (overactive thyroid gland), collagenoses (connective tissue diseases), psoriasis (psoriasis), sarcoid (group of rare diseases associated with leather-like hardening of the connective tissue of the skin)Pterygium inversum unguis -Prominence of the hyponychial tissue of the fingernails, possibly with reaching over to the fingertipsDistal ischemia (circulatory disorder) of the claw skin in sclerodermaPunctiform hemorrhages under the nailsCancer, rheumatoid arthritis, subacute bacterial endocarditis, psoriasis (psoriasis), systemic lupus erythematosus (SLE), gastric ulcer (gastric ulcer)
Pregnancy, traumatic injuryPunctual pitting of the nailAlopecia areata (- 66% of cases), Reiter's disease, psoriasis (psoriasis)Quincke pulse- alternative flushing and fading of the nail bedsevere and chronic aortic regurgitation (poor closure of the aortic valve of the heart)Red Lunula - red nail moon;
normally skin-free, whitish translucent base of the nail bed
Systemic lupus erythematosus (SLE)Black nailsTraumatic hematoma (bruise), Peutz-Jeghers syndrome, vitamin B12 deficiency, after radiation therapy (radiation)Splinter hemorrhage- small streak and streaky brown discolorations of the nail plates, apparently resulting from bleeding.Chronic ischemic heart disease, diabetes mellitus, hyperthyroidism, rheumatoid arthritis, subacute bacterial endocarditis (inflammation of the lining of the heart)Tennis racket nails(racket nails, nails en raquette)), acquiredHyperparathyroidism (overactive parathyroid glands)Drumstick fingers- Rounded distension of the phalanxes of the fingers (end phalanges; fingertips) with thickening of the soft tissueAsbestosis, chronic bronchitis; Endocarditis, inflammatory bowel disease, chronic obstructive pulmonary disease, congenital heart disease, lung tumorsWatch glass nails - Arched nails (ICD-10: R68.3)
 Chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, congenital heart defects, asbestosis, endocarditis (inflammation of the inner lining of the heart), heart valve defects, bronchial carcinoma (lung cancer), chronic bronchitis, chronic obstructive pulmonary disease (COPD), cor pulmonale, pulmonary hypertrophy, osteoarthritis Liver cirrhosis, tumors (paraneoplastic, metastases), cystic fibrosis