FINGERNAIL
DISORDERS:

Nail pitting - a disorder in the fingernail

Nail 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:

Nail pitting in the ring finger nail

SUGGESTIONS FOR FURTHER READING:
Common diseases in the fingernail & toe nail!
News about fingernails!
Fingernails are the barometer of your health!
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Structure of your fingernail: the nail matrix attaches the finger with the nail plate.

The matrix is an ‘invisible’ part of the fingernail – but nevertheless it’s the most important aspect of the nail because nails grow form the matrix!

The process of a growing nail can be described as follows:

Fingernails are composed largely of keratin – a hardened protein which is also present in your skin and hair! As new cells grow in the nail matrix, the older cells are ‘pushed out’, compacted, and take on the familiar flattened, hardened form of the fingernail.

In An Atlas of DISEASES OF THE NAIL the ‘matrix’ is described as follows:


“The matrix of the nail the germinative epithelium from which the nail is derived. There is controversy about whether the nail bed and nail fold contribute cells to the substance of the nail plate. Regardless of this, the matrix is responsible for the majority of the nail plate substance.

The proximal portion of the matrix lies beneath the nail folds and the distal curved edge can usually be seen through the nail plate as the white lunula. The proximal matrix forms the superfiscial portion of the nail plate and the distal matrix makes the undersurface of the nail plate.”

NOTICE: The so-called ‘root’ of the nail is also known as the germinal matrix.


Example of a nail matrix injury (A) + the repairment (B).

Example of a nail matrix injury (A) + the repairment (B).

Example of a normal lunula in a female thumb.

The lunula, or lunulae (a.k.a. the ‘nail moon’), is the crescent-shaped whitish area of the bed of a fingernail (or toenail). The lunula can also be described as the visible part of the nail matrix – which is the ‘root’ of the nail.

The lunula or the white ‘half moon’ at the base or proximal end of the fingernail is particularly smooth, flat and shiny. The whiteness of the lunula is still a matter of controversy but its absence – especialy when the lunula is not present in the first finger (thumb) – could be described as notable and important.

In certain chromosome abnormalities the lunula is absent, i.e., monosomia 4 and the lunulae may be diminished in trisomy 21 (= Down syndrome).

A technical description of the ‘lunuala’ from An Atlas of DISEASES OF THE NAIL:


“…the matrix is responsible for the majority of the nail plate substance. The proximal portion of the matrix lies beneath the nail folds and the distal curved edge can usually be seen through the nail plate as the white lunula.”

Example of a normal lunula in a male thumb.