Salem Wynter-Baxter

Tricholgy Essay 09 The Nails

November 22
Essay 09- The Nails
Please include a detailed account of the physical structure and growth cycles. Mention
pigmentation and diseases (with photographs were possible)
___________________________________________________________________________

This essay will give a comprehensive overview of the biological composition of the nail. The
growth cycles, and any relevant disease pertaining to the nail.

Scritch Scratch:

Let’s start with the definition of a nail!

The nails are basically the human form of a mammal's claws! Nails are a flat version of a
claw, they help us to grip, scratch, climb and complete functions with our hands. They help
us respond to touch and protect our fingertips.

The nails form part of the essential integumentary system of the body, like the skin. Nails
(unlike hair and skin) originate from a very tough or hard form of keratin.

Also defined as:

Accessory organs of the skin. They are made of sheets of dead keratinocytes and are found
on the far (or distal) ends of the fingers and toes. The keratin in nails makes them hard,
but flexible. Nails serve a number of purposes, including protecting the digits, enhancing
sensations, and acting as tools.

Nail Anatomy:

This diagram shows the main components of the nails.

The cuticle also called the eponychium is above the proximal nail fold, not actually
highlighted on the diagram but present also.

The diagram shows the following parts of the nail as listed below.

● Nail plate - rigid portion of the nail

● Free edge-hanging portion
● Body of nail plate (on nail bed)
● Nail root (covered by skin)
● Nail boundary edges of nails sides
● Lateral nail edge
● Cuticle -

Nail Anatomy continued:

This diagram shows the innermost components of the nail, including the matrix, where the
nail matter is actually produced.
 ● How does the nail grow- the stages of the nail growth cycle:

The nail matter or fibre is produced very similarly to hair strand production. Both nails
and hair are made from the tough protein- Keratin, both sites contain a matrix-like
factory that goes into production daily producing the cells we recognise to be hair and
nails.

Nail matrix - this is the epidermis in hyperdrive that consists of cells that constantly divide to
produce keratin matter that becomes the visible nail. They become bags of keratin that lose
their nucleus. Instead, they become full of keratin that makes up the squamous bags of
keratin. As more keratin is produced behind the existing nail it dies, the nail is forced
forward and the squamous keratin becomes the evident growth we see. The nail matrix is
more than one layer of nail cells.

The nail is a very toughened version of the stratum corneum.

Nails are constantly, growing (just like hair). Their growth rate slows down due to poor
circulation and ageing. (like hair).

Fingernails grow faster than toenails, at a rate of 3 millimetres per month. It takes around
six months for a fingernail to grow from the root to the free edge. 1 A Toenail will grow much
more slowly, at just 1 millimetre per month. It takes a toenail 12 to 18 months to grow from
root to tip.
Nail Diseases:

The health or lack thereof, of your nails, is a good indicator (to a medical professional) as to
the internal goings-on within the body. Fungal or bacterial issues with our nails need to be
treated to prevent irregular splitting, nail loss and changes in nail texture and colour.

Nail abnormalities usually show an issue systemically, linked to conditions like

hyperthyroidism and anaemia.

Our nails should be flexible but firm. Weak brittle nails that split easily detail an issue.

Nail Fungus or Onychomycosis

This condition of the nail usually presents itself as discoloured patches of yellow or white on
the nail bed. Nails that split easily, crumble prematurely or extreme thickening of the nail bed
and edge. The nail can also loosen from the nail bed in the presence of a fungal attack.

Jagg
Thic ed
discolo
keni nail
uration
ng edge
of
nail

Most fungal nail infections occur as a result of the fungi that cause the condition athlete's foot to
infect the nails. These fungi often live harmlessly on the skin.

Nail Psoriasis:

Unlike a nail fungus, psoriasis of the nail is an autoimmune condition. The nail matrix
produces too many nail layers as the immune system is overworking.

More than 50% of people with psoriasis will develop nail psoriasis also. People tend to be
more prime if they meet the following conditions;

● Over 40 years old

● Male
● Psoriasis runs in the family
● They have arthritic psoriasis
 Pin
holes
Nail
eaten
away
Nail
crumbli
discolo ng
ured

The presentation:

Psoriasis of the nail exhibits, nail pitting, thickening, pin-like holes in the nail, and nails that
crumble and are full of ridges. It is caused by new nail cells being produced at a rate that is
80% faster than the usual nail production. The nail cycle is reduced from 28 days to 3-4
days. This creates a rash, that spreads from the skin to the nails.

Lichen planus:

Ultimately an inflammatory skin condition that can also affect the nails. The main
presentation is a thinning, severe splitting and ridging across the nail edge and bed. A failure
to get treatment can result in premature nail loss.

Missing nail

Onycholysis:

This is a condition that presents as a separation of the nail from the nail bed. It can be
deemed a result of a skin infection or disease. However, it can also occur due to excessive
filing, a chemical reaction, or an allergic reaction to dermatitis. Failing to treat the condition
effectively and a lack of care during the healing process can result in permanent nail loss.

Paronychia:
 A bacterial or fungal infection of the tissue around the nail. This nail disease causes
inflammation, redness, throbbing, and tenderness of finger or toe tissue around the nail. There
are two types of paronychia—acute and chronic—each with different causes and treatment
methods.

Onychorrhexis:

Also known as Brittle nails. The presentation of this condition is a series of ridges vertical in
nature over the fingers or toenails. There is a wide range of causes, including trauma to the
nail, exposure to chemicals like nail polish remover or harsh household cleaners),
hypothyroidism, anaemia, eating disorders, and more.

Pigmented Nails:

In addition to the nails being subject to a number of infections and diseases, nail pigmentation
better known as Melanonychia is the activation of melanin that is deposited in the growing
nail bed.

The nail matter is largely a translucent material. However, there are incidents and conditions
that mean pigmented nails are more prone to certain racial groups.

Melanonychia:

This condition relates to the discolouration of the nail, it presents as a diffusion in the nail bed
itself or a simple band of darkened colour longitudinal band in the nail.

Benign Longitudinal Melanonychia:

Melanated
band

This condition can be found in men, women and children of all ages however it is found in
the following groups of people more prevalently:

● Men/Women of colour up to 80%

 ● Black people over the age of 50
● Japanese people up to 20%

It can also be a result of genetic issues, medication, skin inflammatory conditions, injury or
trauma to the nail, endocrine issues, local tumours or nail infections.

How is the melanin activated in the nail?

As described earlier, our nails are usually devoid of pigment and largely translucent.
Melanocytes typically lie dormant in the proximal nail matrix where the nail originates.

There are two ways melanin is diffused into the growing nail bed. Namely:

● Melanocytic hyperplasia
● Melanocytic activation.

Melanocytic hyperplasia
Melanocytic hyperplasia, refers to the increased number of melanocytes within the nail
matrix. This can represent a benign or malignant process.

Benign hyperplasia
Melanocytic naevi are more common in children. Histologically there are nests of naevus
cells. Lentigines are seen more commonly in adults. Nests are absent.

Malignant hyperplasia
Melanoma of the nail unit most commonly affects the thumbs, index fingers and big toes.

Melanocytic activation
Melanocytic activation is an increase in the production and deposition of melanin into the nail
cells (onychocytes), without an increase in the number of melanocytes. The causes of
melanocytic activation include many of the nail diseases described earlier. In addition
pregnancy, phytotherapy, endocrine disorders

In conclusion, itis clear to see the nail is subject to the same process of keratinised cell
production , as a continued working progress in the factory matrix underneath the skin of the
finger. A process very similar to the way in which hair is produced.
The nail is subject to a number of conditions and diseases, many induced by fungus or
chemical reactions. As a marker for health the nails are a good indicator as to what is
happening within the body, Medical professionals may deduce a systemic imbalance in the
endocrine system by the appearance of ones nails.

The nail growth cycle is also similar to the hair growth cycle. Being that they are made up of
the same matter type, internal nutrition and care are critical to maintain healthy sttrong nails.
 The Nail Bibliography:

● https://dermnetnz.org/topics/melanonychia

● 10.6 Nails – Human Biology

● https://humanbiology.pressbooks.tru.ca/chapter/12-6-nails/#:~:text=Nails%20are
%20accessory%20organs%20

● SPRINGER (Scher and Daniels) Nails, Adam Rubik, Nathaniel Jellinek, C.

Ralph Daniel, Richard Sher)

Pages 99-101 Nail Psoarias

Pages 245 - Melanonychia

● Nail Psoriasis: What It Is, Causes, Nail Pitting, Treatment

● https://my.clevelandclinic.org › health › diseases › 228.