Nail Diseases
Nail Diseases
Fungal infections affecting the nail are called 'onychomycosis'. It may manifest itself as nail thickening, color change, and breakage....
What are the Most Common Nail Diseases?
Onychomycosis - Nail Fungus
Fungal infections affecting the nail are called 'onychomycosis'. It may manifest itself as nail thickening, color change, and breakage. It is usually asymptomatic and has no accompanying complaints other than shape change. The presence of conditions such as diabetes, immunosuppression, keeping the feet wet for a long time, and accompanying foot fungus facilitates the formation of nail fungus. Topical (applying) or systemic (oral) treatment is arranged according to the degree of nail involvement. However, nail fungus treatment takes a long time. A treatment period of at least 2-3 months is required. Treatment of fungus in toenails takes longer than in fingernails.

ingrown nail
It is called 'ingrown nail' when the outer parts of the nail sink into the soft tissue on the side of the nail bed and create granulation tissue in the form of pain, sensitivity, redness, infection and swelling in that area. It is seen more frequently, especially on the big toes, in young men, and on the outside of the nail compared to the inside. In particular, factors such as improper nail cutting, deep and round cutting, tight shoes, trams, excessive sweating of the feet, staying in shoes for a long time, and obesity can cause ingrown toenails.
We can divide ingrown toenail into 3 stages according to the severity of the clinic.
Stage-1: Redness, pain and edema are observed in the nail fold.
Stage-2: In addition to Stage-1, infection and discharge are observed.
Stage-3: In addition to Stage-2, growth and swelling in the flesh called granulation tissue may be observed.
Treatment of ingrown toenails varies depending on the severity of the clinic.

In stage-1 and stage-2, treatments other than surgery (conservative treatments) are at the forefront. In these cases where the ingrown toenail is milder, methods such as antiseptic foot baths, topical agents that reduce sweating, antibiotics, placing cotton between the ingrown part of the nail and its bend, filing the middle part of the nail, and cutting the nail from the outside and straight are recommended to reduce the infection.
If ingrown toenails are severe, such as stage 3, or in patients with stage 1 or 2 who do not respond to non-surgical treatments, surgical treatment is preferred. In surgical treatment, the ingrown toenail is removed by nail extraction, and the root and matrix of the ingrown toenail are cauterized with a chemical process to reduce the possibility of recurrence of the ingrown toenail in that area. Despite successful treatments, there is a possibility of recurrence of ingrown toenails, albeit low.

Nail findings in eczema
Along with hand eczema, nails can also be affected. Findings such as redness in the nail fold, irregular dot-shaped pits on the nail, transverse white lines (Beau lines), small bleeding under the nail (brown dots), separation in the nail bed (onycholysis), thickening of the nail, curling of the nail (paronychia) and infection in the soft tissue around the nail may be observed.
Nail Eczema Treatment
Treatment of hand eczema is essential in the treatment of nail eczema. It is a priority to prevent anything that triggers eczema, such as frequent water-detergent contact, occupational exposure, chemical contact, trauma, etc. Subsequently, corticosteroid creams and moisturizers can be used to support healing.
Repeat: If the cause of eczema is not eliminated, it is recurrent.

Nail findings of psoriasis
Nail psoriasis (psoriasis) may accompany skin findings in psoriasis patients, or it may occur alone as nail psoriasis without skin findings. Nail involvement is observed in approximately 50% of psoriasis patients. Fingernails are damaged more frequently than toenails. In patients with nail psoriasis, the likelihood of joint involvement due to psoriasis is increased compared to other psoriasis patients, and it can occur together. It is necessary to examine the patient with nail psoriasis from this perspective.

Clinical findings
Ferrule Nail:
 Small dots and pits that appear randomly or regularly on the nail. Bulgur is not specific to psoriasis. Sometimes it can be observed in normal individuals with other disorders such as eczema.
Color change and onycholysis : Color change and onycholysis: Separation and yellow discoloration are observed in the nail bed. The separation is usually at the tip of the nail.
Subungal hyperkeratosis : Nail is dull, thickened, has lost its shine and color, and may also appear yellowish or white. The color may differ in case of accompanying nail infections. It is not a finding specific to psoriasis. It is also frequently seen in nail fungus. The distinction is made by clinical findings and KOH microscopic examination.
Splinter hemorrhage: These are small brown spots that appear due to bleeding in the small vessels in the nail bed.
Nail Psoriasis Treatment
Treatment response in the treatment of nail psoriasis is limited. Local treatments are applied for isolated nail involvement. Systemic treatment options are used in cases of widespread skin psoriasis with nail involvement or joint involvement due to psoriasis.
Reccurance : Unfortunately, since psoriasis is a chronic, recurrent disease, there is a possibility that nail psoriasis may recur throughout life.
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