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Changes in the surface of the nails: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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To the changes in the surface of the nails include point impressions and furrows.
Pointed impressions on the surface of the nail plate are in fact small erosive defects of the nail keratin. Their presence can be a variant of the norm - in a healthy person it is possible to detect up to 5 point impressions on the surface of all twenty nails. Most often, surface pinpoints indicate the presence of psoriasis (a symptom of a "thimble"). Similar manifestations can be in patients with alopecia areata, Reiter's disease, with red flat deer, pink deprive. With eczema, atopic dermatitis, allergic dermatitis, deeper and gross impressions occur. Multiple deep impressions are diagnosed in patients after contact with aggressive liquids (concentrated acids and alkalis) in the workplace using pure acetone to remove decorative coatings or artificial nails.
Furrows on the surface of the nail are longitudinal and transverse, single and multiple.
A single longitudinal groove on the nail plate occurs with the mucoid cyst of the tendon sheath, after a nail injury involving the nail matrix, and also with the central canal degeneration of Heller. In the pathological process, as a rule, one nail is drawn, most often the first finger of the hand. A characteristic symptom of the change in the nail plate is the appearance of the "spruce branch": small and superficial transverse grooves emerge from the deep longitudinal median sulcus. The longitudinal groove can be very deep and lead to a violation of the integrity of the nail. Often there is a wavy course of this idiopathic dystrophy - a smooth nail plate can grow, and later furrow again appear. The main methods of correction of Heller's central channeled dystrophy are the protection of the nail, in particular, using artificial nail technology. Heller's dystrophy should be differentiated from the above conditions, as well as from onychotilomania.
Disturbance of microcirculation in the area of the nail bed is one of the most frequent causes of changes in the surface of the nail. Multiple longitudinal grooves occur in neurocirculatory dystonia, illness in Reynaud's syndrome, diffuse connective tissue diseases (systemic lupus erythematosus, scleroderma, etc.), obliterating endarteritis, atherosclerosis of the vessels of the upper and lower extremities. The simultaneous combination of multiple longitudinal grooves and a serrated edge of the nail plate, indicating an increased brittleness of the nail plate, may be a symptom typical of onychomycosis and Darya's disease.
Crosswise furrows, or Bo-Reilche furrows, may be an indication of a severe somatic or infectious disease suffered (hepatitis, influenza, etc.). Bo-Reilche furrows may indicate a violation of zinc absorption in diseases of the gastrointestinal tract. This phenomenon occurs in such dermatoses as atopic dermatitis, eczema, allergic dermatitis, psoriasis, and low-grade skin lymphomas, and indicates an exacerbation of the underlying disease. Taking into account the high-speed characteristics of nail plate growth, a specialist can specify with certain precision the timing of any adverse effect on the nail matrix.
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