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Nail Dystrophy

Jane was popular with her peers until her fingernails turned black. It began a year ago when her mother noticed that the skin around the nails of the nine-year-old girl was flaky. Tiny holes soon appeared in the nails, which then thickened and changed into an unsightly black. Jane was taken to the National Skin Centre where a sample of her nail was tested.

She was diagnosed with nail dystrophy, a condition where there is disturbed development of the nail - finger or toe - making it look abnormal. Sufferers usually do not feel any pain but their nails can thicken, become scaly, rough, discolored or have lines running across. "Sometimes my friends would tell me that my nails are not very nice. Their mothers tell them not to come near me," says Jane.

Dermatologists say the main causes are congenital (genetic-linked), trauma, fungal infection, skin disease and internal diseases. The affliction can be short- or long-term, strike at any point in one's life and affect both sexes. Congenital nail dystrophy tends to occur in early childhood and there are no known cures. Trauma, caused by nail-biting, wearing tight shoes, manual labor and prolonged walking, can injure nails, causing them to end up looking abnormal.

Sporty people who run may have their toenails rubbing against shoes. The solution is to remove the source of trauma to avoid aggravating the condition. Psoriasis, a chronic inflammatory skin infection, and eczema, a skin problem characterised by redness and itching, are commonly associated with nail changes as well.

Those who do a lot of washing or are in constant contact with a wet environment, like hairdressers and cooks, as well as diabetic patients, are more prone to getting fungal infections. To determine the cause of nail dystrophy, a sample of the nail is taken to test for fungus and see if anti-fungal drugs should be prescribed In non-fungal cases, dermatologists look at the symptoms and prescribe treatment accordingly.

Even if there are no obvious causes, nails can be a telling sign of your internal health. Lung disease or a congenital heart problem may lead to nails becoming `clubbed' like the back of a teaspoon, says experts. He adds that while most nail problems are not life-threatening, there is a cancer of the skin, known as melanoma, which may cause a black discoloratson of part or whole of the nail.

Those having any black discoloration that does not resolve on its own should consult a doctor or dermatologist, who will decide whether the problem is serious. While nail dystrophy is generally not contagious, Dr Jennifer says cooks whose nails are affected by bacteria infection may cause food poisoning, and are advised to stop work. Dr Jennifer says fingernails take four to six months to grow out completely while toenails take 12 to 18 months.

Deformed nails often invite stares. Dr Daniel, a consultant dermatologist, says the problem can be solved by using nail polish or pseudo nails to cover the blemish. As for Jane, it is not known when her nail condition will improve. Her mother says: "We tell her to explain to those friends who laugh at her why her nails are like that. "But she adds: "Jane is getting along fine with her friends now."

Nail Problems: What To Expect

Cause: Trauma from toenails knocking against shoes, nail-biting and constant exposure to wet environment.

Effect: Loss of nail and hang nail (cuticle becomes dry, and nail has small tears and splits). Cause: Bacterial and fungal infection

Effect: Change in color, texture or shape of nails which may thicken. Severe infections can cause nail loss.

Cause: Internal diseases

Effect: Thyroid diseases may produce brittle nails or splitting of the nail. Lung disease or a congenital heart problem may lead to nails becoming "clubbed°, like the hack of a teaspoon.

Cause: Skin diseases like psoriasis

Effect: Pitted, tiny holes in nails, splitting of nail or loss of the nail.


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