In dermatology, nail treatments involve the diagnosis and management of various nail disorders that affect the fingernails and toenails. Nails can reflect systemic diseases, infections, or localized issues. Here’s a detailed overview of nail treatments in dermatology:
Common Nail Disorders Treated in Dermatology
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Fungal Infections (Onychomycosis)
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Caused by dermatophytes, yeasts, or molds.
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Symptoms: Discoloration, thickening, crumbling of nails.
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Treatment:
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Oral antifungals (e.g., terbinafine, itraconazole).
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Topical antifungals (e.g., ciclopirox, amorolfine).
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Laser therapy in resistant cases.
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Nail Psoriasis
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Seen in patients with psoriasis; may appear even without skin lesions.
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Symptoms: Pitting, onycholysis (separation from nail bed), oil-drop discoloration.
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Treatment:
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Topical steroids or vitamin D analogs.
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Intralesional corticosteroids.
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Systemic therapy for severe cases (e.g., biologics).
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Paronychia
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Infection/inflammation of the nail folds (acute or chronic).
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Treatment:
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Acute: Warm soaks, antibiotics, drainage of abscess.
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Chronic: Avoid moisture, topical antifungals or corticosteroids.
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Nail Lichen Planus
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An inflammatory condition affecting the nail matrix.
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Symptoms: Longitudinal ridging, thinning, and pterygium (scarring).
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Treatment:
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Intralesional or systemic corticosteroids.
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Immunosuppressive agents in severe cases.
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Trauma and Nail Dystrophies
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May result from mechanical injury, biting, or repetitive trauma.
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Treatment:
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Behavioral therapy, protective splints.
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Nail hardeners or biotin supplements.
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Melanonychia (Pigmented Bands)
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May be benign (ethnic, trauma) or malignant (melanoma).
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Treatment:
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Dermoscopic monitoring.
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Biopsy for suspicious lesions.
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Ingrown Toenail (Onychocryptosis)
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Nail grows into the surrounding skin.
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Treatment:
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Conservative: Soaks, cotton packing.
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Surgical: Partial or total nail avulsion, phenolization.
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Cosmetic Nail Treatments in Dermatology
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Nail rejuvenation: Use of growth serums, moisturizers for brittle or aging nails.
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Nail whitening treatments: For discolored nails.
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Laser treatments: For fungal infections or pigmented lesions.
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Platelet-rich plasma (PRP): For nail matrix rejuvenation (experimental).
Diagnostic Tools
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Nail biopsy (for suspicious tumors or unexplained nail dystrophy).
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KOH examination and fungal culture (for onychomycosis).
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Dermoscopy of nails (onychoscopy) to assess pigmentation or vascular patterns.
Patient Education & Prevention Tips
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Keep nails trimmed and dry.
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Avoid harsh chemicals and prolonged wetness.
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Use protective gloves during chores.
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Avoid nail-biting or picking.
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Choose breathable footwear to avoid toenail issues.