Nail pitting: the meaning & causes of fingernail pits!

FINGERNAIL DISORDERS: Nail pitting

What is nail pitting? Nail pits are small, round depressions on the surface of the nail plate. They are usually due to disease in the proximal matrix, or sometimes, the proximal nail fold. And the arrangement of the depressions in the surface of the nail is presumably due to the extent and location of the disease in the nail matrix. Random pits in the nail can be seen as an idiopatic finding. When the pitting is uniformly distributed, giving the entire nail plate a roughned appearance, it is called trachyonychia. Treatment of nail pits should be directed to the matrix of the nail. What causes nail pitting? Nail pits are usually the result of: • psoriasis (10-50% of patients have nail pits); • alopecia areata; • eczema; • Reiter’s syndrome; • incontinentia pigmenti; • in children nail pitting can be a normal condition of the nail (not caused by a disease). MORE ABOUT THIS FINGERNAIL DISORDER: Nail pitting – a disorder in the nail

PHOTO – Nail piting in fingernails:

SUGGESTIONS FOR FURTHER READING:
• Common diseases in the fingernail & toe nail!
• News about fingernails!
• Fingernails are the barometer of your health!

Michael Jackson had abnormal fingernails, but not due to his vitiligo & lupus!

Michael Jackson’s fingernails in 2005 (left), 2006 (center) & 2009 (right) – ‘click’ for larger versions! Michael Jackson had abnormal fingernails, but his nails were not related to his vitiligo & lupus! While the first autopsy results related to Michael Jackson’s death were presented earlier this week, there are still many discussions about the state of Michael Jackson’s health – only a few days before his death his health was described by his spokesman Doctor Tohme Tohme as: a ‘perfect health‘. In the perspective of his death it is also important to know that Michael Jackson was diagnosed in 1986 with vitiligo and lupus. Lupus is known as a potentially lethal disease (heart disease is a major complication in lupus!), but in Michael Jackson it was recognized to be in remission. Anyhow, one can still wonder: can his fingernail problems be related to the vitiligo and/or the lupus? The answer to this question appears to be a simple: ‘no’! For, vitiligo is related to the following nail disorders: • Longitudinal striations; • Trachyonychia (thin & lusterless nails); And lupus is related to the following nail disorders: • Nail spooning; • Irregular, twisted, and dilated vessels at the cuticle. CONCLUSION: Out of the 4 described fingernail disorders related to vitiligo and lupus, the 4th can be related to his hand deterioration that was observed in 2009. But none of these fingernail disorders can be related to the typical looks of Michael Jackson’s fingernails during the last 3 years of his life. But one should not forget that Michael Jackson’s fingernail problems were first recognized by the media in 2006, when members of Michael Jackson’s family were terrified that his escalating dependence on prescription drugs had become a danger to his life. While Michael Jackson’s lupus was considered to be in remission, one could also speculate that his hand deterioration + his sudden death might have signaled a lupus relapse … due to an excessive use of prescription drugs??? SUGGESTION FOR FURTHER READING: • In memoriam: ‘The hands of Michael Jackson’! • How Michael Jackson’s autopsy results relate to his hand • Michael Jackson’s hands: a clue to his sudden death? • Michael Jackson’s hands: a manicurist’s worst nightmare! Another example of Michael Jackson’s “unhealthy” dark fingernails:

Fingernail disorders: what are Beau lines?

FINGERNAIL DISORDERS: Beau lines

What are Beau lines? Beau’s lines are horizontal grooves in the nail plate that represent an arrest or slow-down in the growth of the fingernail (more specific: the nail matrix). The depth and width of the Beau line reveals the abruptness and duration of the causal event, and Beau lines move distally with the growth of the nail plate. This finger nail condition was named by a French physician, Joseph Honoré Simon Beau (1806–1865), who first described the condition in 1846. What causes Beau lines? Beau’s lines are usually caused by: • a sever medical event; • allergic reaction to medication; • infection in the nail fold; • skin disease; • systemic disease; • or a serious trauma. MORE ABOUT THIS FINGERNAIL DISORDER: Beau line – a fingernail disorder

PHOTO: Beau lines in various fingernails:

SUGGESTIONS FOR FURTHER READING:
• Fingernail disorders in the hands of children!
• Fingernail disorders in elderly patients!
• Michael Jackson had abnormal fingernails!

Fingernail disorders in the hands of elderly!

At atlas of diseases of the nail!

Fingernail disorders in the hands of elderly! Fingernail disorders in the hands of the elderly are actually quite normal. One could say that Elderly people carry the last 6 months of their medical record on the approximately 10 square centimeters of keratin comprising the fingernails! Abnormalities of the nail are often caused by skin disease and fungal infection. But fingernail disorders may also indicate more general medical conditions.

When examing the nails it is useful to follow a sequence including these steps: • Check the nail shape; • Examine the nail color; • Survey processes around the nails; • Compare hands; • and note skin conditions. A few of the most common fingernails disorders in the elderly related to the fingernail shape & nail surface are: clubbed fingernails, koilonychia, Beau lines, brittle nails, onychorrhexis, nail pitting, median nail dystrophy, nail beading, rough nail surface, nail thickening, onycholysis, and severe nail curvature. A few of the most common fingernails disorders in the elderly related to the finger nail color are: absent lunula, pyramidal lunula, lunula with red discoloration, transverse white lines, leukonychia striae, longitudinal brown lines, splinter hemorrhages, Terry’s half and half nails, white nails, pink or red nails, brown/gray nails, yellow nails, and green or black nails. More details about these nail disorders (and many others) will be revealed in later contributions.

Fingernail disorders in the hands of children!

Fingernail disorders in the hands of children!

Fingernail disorders in the hands of children! Many people consider fingernail disorders merely as a ‘cosmetic problem’, nevertheless fingernails provide important signs related to your health. Let’s take a look at the fingernails of children! The long version of this article describes the normal development of fingernails during childhood, including some ‘normal’ nail disorders (which are usually harmless) + an overview of the ‘serious’ nail problems in infants & children.

The following nail problems are relatively normal fingernail disorders in the hands of children (usually these are ‘harmless’): (1) Beau’s lines, (2) fragile nails, (3) pits of the nail plate, (4) koilonychia, (5) v-ridging (chevron nails), (6) punctate leukonychia, and (7) periungual pigmentation. You can read more about the ‘harmless’ nail disorders in children, at: • Normal fingernail disorders in the hands of children However, many other nail disorders are often related to various congenital, familial or acquired disorders. Examples of these ‘worrisome’ fingernail disorders in the hands of children are: (A) anonychia, (B) micronychia, (C) polyonychia, (D) epidermolysis bullosa, (E) pachyonychia congenita, (F) ectodermal dysplasias, (G) veillonella infection, (H) ingrowing toenail in infancy, (I) racket nails, and (J) the nail-patella syndrome. You can read more about the ‘worrisome’ nail disorders in children, at: • Worrisome fingernail disorders in the hands of children