Nail dystrophy refers to abnormalities in the appearance and structure of the nails, including changes in colour, shape, thickness, and texture. This condition can affect one or more nails and can be caused by a variety of factors, ranging from trauma to systemic diseases. Understanding the underlying causes of nail dystrophy is crucial for accurate diagnosis and appropriate treatment. Below are some of the primary causes:
1. Trauma
Physical Injury: Direct trauma to the nail, such as crushing or repetitive pressure, can lead to nail dystrophy. This is common among individuals who engage in activities that put stress on the nails, such as athletes or those who frequently use their hands in manual labor.
Chemical Exposure: Regular exposure to harsh chemicals, including certain nail polishes, removers, and cleaning agents, can damage the nail matrix and result in dystrophy.
2. Infections
Fungal Infections (Onychomycosis): One of the most common causes of nail dystrophy, particularly in toenails. Fungal infections can cause thickening, discolouration, and crumbling of the nails.
Bacterial Infections: Bacteria can invade the nail bed, leading to discolouration and deformities.
Viral Infections: Viruses, such as human papillomavirus (HPV), can also affect the nails, causing changes in their appearance and structure.
3. Dermatological Conditions
Psoriasis: Psoriasis can affect the nails, leading to pitting, discolouration, and thickening. Nail involvement is common in people with psoriasis and can be a source of significant discomfort.
Eczema: Chronic eczema, especially on the hands, can cause changes in the nails, including ridging, splitting, and thickening.
Lichen Planus: This inflammatory condition can cause thinning and grooving of the nails, often leading to their destruction if untreated.
4. Systemic Diseases
Thyroid Disorders: Both hypothyroidism and hyperthyroidism can lead to changes in nail texture, brittleness, and onycholysis (separation of the nail from the nail bed).
Diabetes: Poor circulation and immune dysfunction in diabetes can predispose individuals to nail infections and dystrophy.
Lung Disease: Conditions such as chronic obstructive pulmonary disease (COPD) can cause "yellow nail syndrome," where nails become thick, yellow, and slow-growing.
5. Nutritional Deficiencies
Iron Deficiency (Anemia): Iron deficiency can lead to koilonychia, a condition where the nails become thin and spoon-shaped.
Vitamin Deficiencies: Deficiencies in vitamins such as biotin, vitamin B12, and folic acid can result in brittle, ridged, or discoloured nails.
6. Medications
Chemotherapy: Many chemotherapy agents can cause nail changes, including pigmentation changes, ridging, and separation of the nail from the nail bed (onycholysis).
Retinoids: High doses of retinoids, often used for treating severe acne or psoriasis, can lead to nail fragility and dystrophy.
7. Genetic Factors
Congenital Nail Dystrophies: Some individuals are born with nail dystrophies due to genetic mutations. Conditions like pachyonychia congenita or nail-patella syndrome can lead to severe nail deformities from birth.
8. Aging
As individuals age, nails naturally become more brittle, ridged, and discolored. Aging can exacerbate the effects of other causes of nail dystrophy.
Nail dystrophy can result from a wide range of causes, from trauma and infections to systemic diseases and nutritional deficiencies. A thorough medical history and examination are essential to determine the underlying cause and guide treatment.
Addressing the root cause of the dystrophy is crucial to improving nail health and preventing further damage. In some cases, specialized treatments such as antifungal medications, corticosteroids, or supplements may be necessary, while in others, simple lifestyle changes or protective measures can significantly improve the condition.
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