Lecture of Ch 10 Milady

1. MILADY
NAIL DISEASES &
DISORDERSThe HOW and WHY :Disorders. Infections. Diseases.

3. TUESDAY- Intro to why we study the diseases & disorders; Hangnails
WEDNESDAY- Leukonychia to Nail curvatures
THURSDAY- Nail infections to diseases of the nail
FRIDAY- Tissue inflammations; Review for both chapters

4. THE NATURAL NAIL- Health & Tips
• A normal healthy nail is firm but flexible
• Shiny, smooth & unspotted
• No ridges, pitts or splits
• Whitish, translucent with pink color of nail bed showing
through
•Don't cut or manipulate cuticles- CUTICLE is your natural proctection
•Use nail hardeners sparingly -- or not at all.
•Moisturize the nail, skin and the cuticle.
•Take biotin supplements- metabolize macros-make aminos
•Limit professional manicures- too many harsh chemicals
•Avoid acetone-based polish removers- strips natural oils/ dries out skin
•Avoid rough emery boards
•Don't overdo hand washing and limit contact with cleaning chemicals.

5. NAIL DISORDERS
A Nail Disorder is a condition caused by
INJURY, DISEASE or IMBALANCE
If an area is inflamed, infected, broken
or swollen it should be referred to a
doctor

6. Bruised nails
• No applied pressure
• Pressure can be relived by Dr
Eggshell nails
• Flexible
• Diet
• Happens in Matrix
• Vitamin A- Cell division
• Medication- inhibit flow of
nutrients

7. Beau’s Lines
• Depressions you can feel
• Width/Horizontal
• Illness, injury, pregnancy , stress/ low immune
• Interrupted growth- certain areas produce less cells
• Keratin synthesis doesn’t happen
• ON ALL NAILS- systemic disease, poor circulation,
heart problems
Hangnail
Agnail
• Living skin
• Eponychium
• Perionychium
• Soften then cut
• Oil/moisturize
• Not taking care
of cuticle

8. REVIEW
• How could you identify a nail disorder?
• Some ways to keep your hands and nails
healthy?
• Can I treat a bruised nail?
• Thin, flexible nails that fold over the free edge?
• Depressions that run horizontally? Caused by
what?
• How can you prevent Hangnails?

9. Koilonychia- Spoon Nails
• Flat then concave- Nail Bed
• Anemia
• Low Iron- Low red blood cells
• Celiac Disease
• Petroleum Products-
22% Dioxane ( carcinogen ) 82% in
haircolor, 45% in self tanners, 36%
face mositurizers
• Abnormal white cell production
impairs red cells- transport oxygen
Leukonychia
• White spots
• Injury to MATRIX
• Compression of capillary
flow: organ failure
• Zinc/Calcium deficiency-
protein synthesis
• Early stages
Onychomycosis
• Air bubbles

10. Blue Nails
• Lack of oxygen
• Blood diseases: red blood cells produce oxygen
• Heart/Lung- lack of returned oxygenated blood
• Cold/Frostbite
• Raynaud's; Diabetes; Lupus- all restrict blood flow
Melanonychia
• Darkening of the nail ( Band )
• Increased melanocytes
• Active- deposits of melanin
• Hyperplasia- increase in pigment cells
• Melanoma
• Fungal infection

11. Discolored Nails
• Surface Staining
• Poor circulation
• Smoking- tar stains yellow; blocks oxygen flow
• Medications
• Fungus ( Green )
Onychophagy
• Bitten nails
• Compulsive nail biting
• Need frequent manicures

12. Onychorrhexis
• Split/ Brittle nails
• Injury
• Harsh chemicals: Thio,
Alkaline
• Acetone/Cuticle remover
• Aggressive filing
• Hypothyroidism- hormones
responsible for hair/skin/nail
growth
Plicatured Nails
• Folded nail
• Highly curved
• Can lead to Ingrown nail
• Hereditary
• Injury
• Highly curved matrix

13. Nail Pterygium
• Means wing like membrane
• Skin & nail adhesion
• Folds fuse with matrix
• Damage to eponychium &
hyponychium
• Lichen Planus, Raynaud's,
Trauma/burns
• Nail plate cells slow but skin
does not
Ridges
• Vertical
• Uneven growth of nails
• Lack of cell production
• Nutrient deficiency
• Buff; ridge filler

14. Splinter Hemorrhages
• Physical trauma
• Damaged capillaries
• Oxidized blood
• Asprin
• AutoImmune
• Slow healing

15. INCREASED CURVATURE NAILS
Curve at free edge; the greater the curvature
of the matrix, the greater the curve at the
free edge
Pincer. Trumpet. Onychogryposis. Onychocryptosis

16. INCREASED CURVATURE NAILS
PINCER NAILS
TRUMPET NAILS
Ill fitting shoes
Old age
Arthritis
Fungus
Curved Matrix
Improper filing
No real known cause

17. INCREASED CURVATURE NAILS
Onychogryposis
• “ RAMs HORN
• Hypertrophy
• Thickening or enlargement
• Fungal infection
• Vascular disease- causes arteries in
leg to build up plague
• One side grows faster
• Trauma
• Exact cause is unknown
• Age- lack of new cell growth
• Surgery

18. INCREASED CURVATURE NAILS
Onychocryptosis- Ingrown nails

19. REVIEW
• White spots on the nails? What can cause them?
• Increased pigment, can be a precursor to melanoma?
• Spoon nail, often a result from iron deficiency?
• What can cause blue fingernails?
• What can cause discolored nails?
• Bitten nails?
• Brittle nails from harsh ingredients?
• What is it called when the folds fuse with the matrix?
Wing like stretch of skin
• Examples of curved finger nails?

20. NAIL INFECTIONS

21. NAIL INFECTIONS
FUNGI-
Parasites that cause infection
Grow & thrive in warm, dark, moist places
Contagious- unclean implements
3 kinds- MOLD, YEAST, TINEA
Green- Bacteria. White- Yeast

22. NAIL INFECTIONS
• Discolorations are caused by a bacterial
infection; it is NOT MOLD
• Yellow / Green is sign of bacterial infection
• Red, pain, pus, swelling
• DO NOT treat; refer to Doctor

23. NAIL INFECTIONS THE GREENIES- PSEUDOMAS AERUGINOSA
• Bacterial infection
• Bacilli Pathogen
• Starts as a small yellow discoloration
• Found mostly in water
• Antibiotics
• Artificial nail- Moisture trapped; un adhered nail
• Water evaporates; leaves minerals ( ART. nail )
• Unclean implements

24. 1.Wear flip flops or shower sandals when walking in
warm, moist areas like gyms, locker rooms, spas, public
showers, and pools.
2. Fungus can live in footwear, if getting over a previous
fungus get rid of old shoes.
3.Put on a clean pair of socks every day and whenever
your socks get sweaty. This helps prevent fungi from
growing.
4.Wear shoes that:
•Fit well (not tight)
•Are made of leather, canvas, or mesh
•Keep your feet dry and prevent overheating
This helps prevent fungi from growing in your shoes.
5.Alternate shoes. Fungi thrive in moist
places like damp shoes. You can reduce
this growth by giving shoes 24 hours to
dry out before wearing them again.
6.Keep your nails short; straight across &
not rounded at corners. This helps prevent
fungi and other germs from getting under
your nails.
7.Sanitize your nail clipper before using
it. Never share nail clippers, shoes etc.
8.Keep feet clean & dry; avoid having
damp or sweaty feet for too long
9.Moisturize dry skin. Fungi can get in
through small cracks in your skin;
moisturize within 5 minutes of bathing
and after washing your hands.
TIPS TO PREVENT SPREADING OF BACTERIA/FUNGI

25. DISEASES
OF THE
NAIL
ONYCHOSIS
Any deformity,
disorder or disease
of the nail
Ends in SIS/OSIS- means disease

26. DISEASES OF THE NAIL
ONYCHIA
( chia means inflammation)
• Inflammation of the nail matrix/ the nail itself
• Pus & eventual shedding of the nail
• Caused by skin openings in nail fold or poor fitting shoes
• Bacteria, fungi
• Improper disinfected implements
• Remove nail- drain pus
ONYCHAUXIS
• Thickening of nail plate
• Hypertrophy/ extreme Psoriasis
• Injury- constant trauma
• Diabetes- or any low circulation
• Repetition- natural protection
• Old age- less cell production
• Prone to Nail infections
• NOT CAUSED BY FUNGUS

27. DISEASES OF THE NAIL
ONYCHOLYSIS
ONYCHOMADESIS
• Lifting of nail plate
• “Painless”
• Starts at top/ free edge
• Does NOT ALWAYS shed nail
• Bacteria/ Fungus/Yeast
• Repetitive tapping
• Allergic reaction
• Psoriasis
• Trauma
• Manicure tools under nail bed
• Removal of ART. nails
• Separation of nail plate from bed
• Starts at base of nail
• Eventual falling off ( will fall off )
• Cessation of nail cell production
• Loss of blood supply
• Injury/ Local Infection
• Medical treatments- Chemo

28. REVIEW
• What is a fungus? What conditions does it need
to survive?
• Pseudomas aeruginosa is a bacteria or a mold?
• Name for any disease of the nail?
• Inflammation of the matrix; small openings that
allow bacteria in?
• Thickening of the nail?
• Lifting of nail plate from free edge; with or
without shedding of nail?
• Lifting AND falling off of nail from base

29. DISEASES OF THE NAIL-
NAIL PSORIASIS
• Autoimmune
• Tiny pits, rough patches on nail
• Looks like nail has been
aggressively filed
• Can be yellow, brown, red
under the nail
• Seen with plague psoriasis
• Painful
PYOGENIC GRANULOMA
• Severe inflammation
• Tissue grows from bed to plate
• Benign tumor/ Staph infection
• Bleeding/ painful; can become calcified
• No known cause; rapid capillaries/ blood
vessel growth
Starts with a P-
refers to tissue

30. DISEASES OF THE NAIL-
PARONYCHIA
( Chia means inflammation )
Starts with a P-
refers to tissue

31. DISEASES OF THE NAIL
ONYCHOMYCOSIS
• Tinea unguium- ring worm of the nail
• Fungal Infection of nail
• Effects whole nail plate
• Contagious- oral medication may be
needed
• Foul smell
• Pain/discomfort
Tinea means fungal infection
TINEA PEDIS
• Fungal infection
• Ring worm of foot
• Contagious
• Athletes foot
• Itchy blisters; sole and inbetween toes
• Thrives in warm, moist, dark places
• Showers, gyms, pools, locker rooms

32. REVIEW
• Bacterial infection of the tissue around the
nail?
• Severe inflammation with an exposed lump of
tissue?
• Athletes foot?
• Fungal infection causes eventual crumble of
nails, highly contagious