APRIL 5, 2008

Examining Fingernails in elderly patients (4/5)
Abnormalities of the nail are often caused by skin disease, infection & medical conditions.

Author: Mark E. Williams - Medscape.com

Content:

INTRODUCTION
OBSERVING THE NAIL SHAPE AND SURFACE
OBSERVING THE NAIL COLOUR
PROCESSES AROUND THE NAIL
CASES


PROCESSES AROUND THE NAIL


Paronychial Inflammation:

Paronychia is associated with separation of the seal between the proximal nail fold and the nail plate that provides entry for bacteria and leads to a localized infection of the paronychial tissues of the hands (Figure 29). Symptoms may include inflammation, swelling, and/or scaling.




Figure 29: Example chronic paronychial inflammation.

Chronic paronychia inflamation nail

Mucus Cyst:

A mucous or myxoid cyst is a collection of degenerative collagen that can cause swelling and ridging of the nail above the cyst, forming a "gutter" (Figure 30).














Figure 30: Example of a mucus cyst.

Mucus cyst

Periungal Telangeictasia:

Periungal telangeictasia is caused by dilated capillary loops and results in atrophy of the cuticle (Figure 30). It is strongly associated with collagen vascular disease, including the following:

• Systemic lupus erythematosus;
• Dermatomyositis (especially with Gotton's papules over knuckles);
• Scleroderma.


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