Nail Abnormalities

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Nail Abnormalities: Common Causes

Trauma

• A crush injury to base of the nail or the nail bed may produce a permanent deformity
• Nail biting can be a sign of anxiety, chronic tension or uncontrollable compulsion
• Chronic picking or rubbing of the skin behind the visible portion of the nail can produce a washboard nail
• Chronic exposure to moisture or to nail polish can produce brittle nails with peeling of the edge of the nail

• Fungus or yeast produce changes in the color, texture, and shape of the nails
• Bacterial infection may cause a change in color (green nails with Pseudomonas) or painful pockets of infection under the nail or in skin surrounding the nail -- severe infections can cause loss of the nail plate
• Viral warts may cause a change in the shape of the nail or ingrown skin under the nail

• Disorders that affect the amount of oxygen in the blood (such as abnormal heart anatomy and lung diseases including cancer or infection) may produce "clubbing" of the nail, which looks like the back of a teaspoon
• Kidney disease that causes a build-up of nitrogen waste products in the blood
• Liver disease including chronic liver failure
• Thyroid diseases including hyperthyroidism or hypothyroidism may produce brittle nails or splitting of the nail bed from the nail plate (onycholysis)
• Infection (especially of the heart valve) may produce splinter hemorrhages (red streaks in the nail bed)
• Systemic amyloidosis
• Severe illness or surgery may produce horizontal depressions in the nails (Beau's lines)
• Vitamin deficiency can cause a loss of luster or brittle nails
• Malnutrition of any sort can affect the appearance of the nails

• Psoriasis may produce pitting, splitting of nail plate from nail bed (onycholysis), and chronic destruction of the nail plate (nail dystrophy)
• Lichen planus

• Arsenic poisoning may produce white lines and horizontal ridges
• Silver intake can produce a blue nail