Changes in the shape of the nails: causes, symptoms, diagnosis, treatment

The most common options for changing the shape of nail plates are coilonichia and bulging nails like "watch glass".

Coylonikhia is a special kind of onychodystrophy, manifested by concave nails. Small thickness or thinning of the nail plate is the common cause of all koylonichias. Coilonihia occurs in newborns, children of the first year of life and in persons with congenital ectodermal dysplasia. The thickness of the nail plate is affected by chronic iron deficiency, hemochromatosis, long-lasting infectious diseases. Thinning occurs with a systematic chemical impact on the nail (contact with chemicals in the workplace and at home, the use of decorative coatings and liquids to remove varnish with a high content of acetone, prolonged wearing of artificial nails, etc.). Coylonihia - a characteristic symptom of pi red flat lichen, to a lesser extent - for psoriasis and onychomycosis.

Nail dystrophy by the type of "watch glass", often occurs on the nail plates of both hands or on all nail plates, usually due to chronic diseases of the lungs and bronchi. The mechanism of its development is associated with a change in microcirculation in the nail bed area. Dystrophy of the nail plates by the type of "watch glass" is a symptom of such diseases as bronchoectatic disease, chronic pneumonia, pulmonary emphysema, pulmonary tuberculosis, bronchogenic lung cancer, long-term medication-compensated pneumocystis pneumonia, etc. In addition, often a type of "watch glass" combined with hypertrophy of the tissues of the terminal phalanges of the fingers and the formation of so-called "drum sticks". However, in addition to diseases from the respiratory system, diseases of the cardiovascular system can also lead to the development of this symptom complex (compensated and subcompensated heart defects, benign atrial and ventricular tumors that lead to hemodynamic disorders), gastrointestinal tract (cirrhosis, chronic active hepatitis, Crohn's disease, ulcerative colitis, intestinal cancer, etc.), endocrine system (autoimmune thyroiditis). In asymmetric nail lesions, only one limb should be used to diagnose osteochondrosis. The compression of the neurovascular bundle is also likely in case of spinal injury, damage to the brachial plexus, aortic or subclavian aneurysm, as well as with enlarged lymph nodes (tuberculosis of the intrathoracic lymph nodes, cancer, metastatic processes) and as a result of adhesive processes

The defeat of one nail plate by the type of "watch glass" may be due to benign or malignant lesions in the nail bed (mucosal cyst of the tendon sheath, glomus tumor, angioliomioma, basal cell carcinoma, etc.). Cosmetologists and pedicure specialists are not recommended to impose special staples on the nail plate in order to smooth out its surface without a preliminary analysis of the causes of onychodystrophy by the type of "watch glass", since in these diseases early diagnostics and timely treatment are important.

There are other options for changing the shape of the nails. When ingrown, and also after improper removal of the nail or part of the nail plastic, its shape can change substantially, both in the area of the hands and feet. Perhaps also a peculiar change in shape, which is commonly called a racket-like nail. With this variant of onychodystrophy, the nail plate is sharply shortened and enlarged. As a rule, the first fingers of the hands are symmetrically affected, cases in the family are not uncommon. This condition is based on an innate shortening of the terminal phalanx of the fingers. The indicated onychodystrophy can occur in the distal form of psoriatic polyarthritis as an acquired version of the racquet-like nail. With this pathology, shortening of the phalanx is due to the severity of joint damage and osteoporosis.

[1], [2], [3], [4]