Nails, part II: Dystrophic changesBeau lines

Also called "Lines Bo" or «Bo-Reyli's Lines» (fig. 7). A symptom for the first time described by the French doctor of Joseph HonorA© Simon Beau (1806-1865), as cross-section concave lines on the nail plate, arising owing to sharply arisen disease. Depth of the line in a certain measure corresponds to weight of defeat of a matrix of a nail. On colour of the line Bo do not differ from other nail plate. In depth can reach 1 mm.

Beau Line drawing 7

The pathology most often causing emergence of the Beau lines:

  1. Heavy infection
  2. Myocardial infarction
  3. Hypotension, shock
  4. Gipokaltsiyemiya, deficiency of zinc
  5. Surgical interventions
  6. Intermittiruyushchey introduction цитостатиков.

Considering growth rate of a nail (a hand of 1-2 mm/weeks,) initial time of impact of pathological process is possible to calculate feet of 0,25-1 mm/weeks approximately.

Longitudinal furrows of nails (fig. 8) They correspond to horn ledges of the bottom surface of a nail plate. The longitudinal furrows which are combining with longitudinal combs on a surface of a nail, can be formed and at persons of young age, but more often they meet at age changes or at diseases (for example, red flat herpes). Longitudinal furrows of nails can be observed and at healthy people.

Nails, part II: Dystrophic changes

Drawing 8 Longitudinal furrows of nails

Gapalonikhiya (hapalonychia) - a softening of nail plates that leads to their excesses, splitting with formation of cracks up to expansion of the free edge getting a fanlike form. Distinguish the true gapalonikhiya resulting endocrine dysfunctions, violations of exchange character, spastic paralysis and other diseases, and also the secondary gapalonikhiya which is forming as a result of local impact on nails of various chemical and mechanical agents (alkalis, acids, solvents, etc.).

Fragility of nails (fragilitas unguinum) is formed owing to contact to acids, alkalis, solvents, etc. Also it is observed at the women who are often doing manicure, as a result of a trauma, impact on a nail of acetone, a varnish, a xylol and other substances. It is clinically shown by an oblamyvaniye of all free edge of a nail or only him the top (brilliant) layer.

Naperstkovidny, or dot, istykannost of nails (onychia punctata, син. «the thimble symptom») (fig. 9) In literature can be met that these changes of nails can be observed at almost healthy people that is disputable. Most often the symptom meets at psoriasis, is frequent for 5-7 years advancing emergence of defeat of skin. Detection of «a thimble symptom» also often precedes emergence of psoriatichesky arthritis. Also it is found at eczema, and also a number of diseases of not dermatological profile (tuberculosis of lungs, rheumatism, etc.). Dot poles have size from the several tenth millimetre to 1 - 1,5 mm and depth to 1 mm. The number of deepenings (dimples) fluctuates from 2-3 to several tens. Their emergence is connected with changes both a nail bed, and a matrix.

Nails, part II: Dystrophic changes

Drawing 9 "thimble" Symptom

Onikholizis (onycholysis; онихо + Greek lysis razvyazyvany, division) (fig. 10) - full or partial separation of a nail plate from a nail bed. The disease is described by Heller in 1910. The separation of a nail from a nail bed occurs from free edge more often, but can begin and with its lateral edges. The separated part (or parts) a nail plate gets whitish-grey colouring. More often the nail plate separates from a nail bed not completely. The development reasons онихолизиса are diverse: intoxications, neurotrophic frustration, traumas, manifestations of skin diseases (psoriasis, eczema, congenital эпидермолиз, etc.), bacterial and, especially, fungoid infections, for example, рубромикоз nails.

Nails, part II: Dystrophic changes

Drawing 10 Onikholizis

Onikhomadezis (onychomadesis; онихо + Greek madesis baldness; син.: онихоптоз) - complete falling away of a nail plate at which it loses touch with matriksy and separates at the proksimalny roller that distinguishes this process from онихолизиса. Process proceeds in short terms with the inflammatory phenomena or without them. The reason онихомадезиса not always manages to be found out. The disease can arise as complication of an injury of a distalny phalanx of a finger with violation of function of a matrix of a nail, an infection (fungoid (Candida), kokkovy flora); gnezdny allopetsiya, psoriasis, hereditary эпидермолиза.

Onikhoklaziya (onychorhexis; онихо + Greek rhexis withdrawal pains, crushing; син. онихорексис) - fragility, splitting of nails in the longitudinal direction. Onikhoreksis can arise at mechanical traumas, chemical influences, a number of diseases of endocrine system (violation of an ovarialny cycle), eczema, psoriasis, red flat herpes, etc. As a rule, to be surprised separate nails of fingers of brushes, is more rare - stop. At the bottom of longitudinal furrows, since free edge of a nail, the cracks which are often reaching its proksimalny department are formed.

Shizonikhiya (onychoschisis; онихо + Greek schisis splitting; син. онихошизис) - splitting of nails in the cross-section direction - parallel to free edge of a nail. Distinguish symmetric lamellar stratification of a nail plate and splitting of nails in the middle. As a rule, nails grow normally almost to free edge, but then start to be split on one or several fingers. Often develops as a result повторяющиейся traumas of free edge of a nail, for example, at the musicians playing string instruments, the women who are excessively fond of manicure, etc. Onikhoshizis is often observed at patients with eczema and the red flat is deprived.

Onikhodistrofiya similar to laths of a roof (onychodistrophia schindalamoides) (fig. 11), as a rule, meets at elderly people. It is shown it is longitudinal the located multiple parallel furrows. Most often arises at diabetes, violations of function of a thyroid gland, nadpochechnikovy insufficiency, deficiency of vitamins of group B.

Nails, part II: Dystrophic changes

Drawing 11 Onikhodistrofiya similar to laths of a roof

Pterigium of a nail (pterygium unguis; Greek pterygion something similar to a wing) (fig. 12) - a hypertrophy an eponikhiya at which it in the form of a wing accrues on a nail, being attached to its surface. There is a growth and a prirastaniye to a nail plate of a nail thin skin from the back nail roller and its flow on a nail. It is described as congenital anomaly, and also at a sklerodaktiliya, obliterating эндартериите, red f
lat herpes, also other diseases, being characterised violation traffic of nail phalanxes of fingers of brushes, are more rare than feet.

Nails, part II: Dystrophic changes

Drawing 12 Pterigium of a nail

Senile nails (ungvi senilis) (fig. 13) - dim, a grey-yellowish shade. Longitudinal furrows in the heart of which the cheshuyka arising owing to splitting of a nail plate are formed are often observed. Blood circulation violation in the field of a matrix and a nail bed on fingers of brushes and feet result. At elderly and old people the onikhodistrofiya similar to laths of a roof (see below), median kanaloobrazny dystrophy of nails, klyuvovidny nails is also often observed. Nail plates at a senile onikhodistrofiya can have different thickness, nail lunochka become less expressed, growth of nail plates is slowed down.

Nails, part II: Dystrophic changes

Drawing 13 Middle kanaloobrazny dystrophy of nails

Median kanaloobrazny dystrophy of nails (dystrophia ungvium, medicina canaliformis) (fig. 13) - is characterised by emergence on nails к.п. thumbs of brushes, it is essential less often - stop, the wide longitudinal channel. Can have family character. Being formed on thumbs of brushes the middle furrow can be a various origin: repeated trauma, violations of peripheral blood supply and neurovegetative system. At some patients the course of a disease is characterised by the periodicity connected over time of year.

Uzura of nails (ungues usurati) - deleting, wear process of free edge of a nail. Education узур is connected with a trauma of a nail plate of professional character, расчесами strongly itching centres at a number of diseases of skin. The free edge is more often than II, III, IV (seldom others) fingers of the right (left) brush looks ground off, sometimes slanted. A surface of nail plates glyantsevidny, shining.

List of references

  1. Differential diagnostics of skin diseases. The management for doctors. Under B.A.Berenbeyn, A.A.Studnitsina's edition, M, Medicine, 1989, 672 pages.
  2. Ilchenko V.A. Fizikalnye research methods. Diseases of respiratory organs. In book. «The guide to internal diseases» / Under Paleev N. R. M. edition: Medicine. 2000.
  3. Propaedeutics of internal diseases: (studies. lighted. for the student. honey in-tov) under the editorship of V.H.Vasilenko. - 3rd prod., reslave. and additional - M: Medicine, 1989.
  4. Scher RK. Acquired immunodeficiency syndrome and yellow nails. J Am Acad Dermatol. 1988; 18 (4 pt 1):758-9.
  5. Samman PD, White WF. The ‘yellow nail’ syndrome. Br J Dermatol. 1964; 76:153-7.
  6. Fatourechi V, Ahmed DD, Schwartz KM. Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period. J Clin Endocrinol Metab. 2002; 87:5435-41
  7. Baran R, Dawber RPR, De Berker D, Haneke E, Tosti A, eds. Baran & Dawber \\\\\\\'s Diseases of the Nails and Their Management. 3rd ed. London, UK: Blackwell Publishing; 2001.
  8. Fleckman P, Lee J, Astion ML. Nail-Tutor: an image-based personal computer program that teaches the anatomy, patterns of pathology, and disorders of the nails. Dermatology Online Journal. 1997; 3 (2):2. http://dermatology.cdlib.org/
  9. Williams ME. Assessing the hands and wrists in elderly people. 2006. Medscape. http://www.medscape.com/viewprogram/5202/
  10. Samman PD, White WF; The "Yellow nail" syndrome. Br J Dermatol. 1964 Apr; 76:153-7.
  11. Razi E; Familial yellow nail syndrome. Dermatology Online Journal 2006, 12 (2):15.
  12. Tom DW, Scher RK. Biopsies of nails. Melanonychia striata in longitudinem. Am J Dermatopathol 1985; 7 suppl:161-3.
  13. Miura S, Jimbow K. Clinical characteristics of subungual melanomas in Japan: case report and a questionnaire survey of 108 cases. J Dermatol 1985; 12 (5):393-402.
  14. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews \\\\\\\' Diseases of the Skin: Clinical Dermatology. (10th ed.).
  15. Schwartz RA, Vickerman CE. Muehrcke’s lines of the fingernails. Arch Intern Med. 1979; 139:242.


About what can tell nails>>>
Nails, part I: Changes of a form and sizes>>>
Nails, part II: Dystrophic changes>>>
Nails, part III: colour changes>>>
Nails, part IV: Dark blue, red, brown nails>>>

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