Nail & Skin Disorders

Nails Under The Microscope - Understanding Nail Anatomy & Disorders

Nail technicians should know as much about the inside of the nail as the outside. Here’s an anatomy lesson on the onychium. Pay attention – there’s going to be a test at the end.

The most common nail condition seen, onychomycosis (fungal nail infection), may occur in young children, although it occurs more frequently in adults. When nail fungus does appear on children’s nails, it is usually associated with a similar infection in one or both parents. The source of the infection, therefore is a parent; many times being related to someone who is prone to onychomycosis (the parent in this case) will leave the child susceptible to onychomycosis, too. Recent data have shown that in a high percent of cases, susceptibility to onychomycosis in inherited. With respect to post-pubertal teenagers, nail fungus can also occur, but overall incidence is also somewhat lower than in adults. The tendency among dermatologists is to treat children with local medications only, such as antifungal creams, gels, solutions, and powders. Because of their side effects, oral medications are generally limited to adults, although in severe or resistant cases they may also be used on children.

Psoriasis of the nails also affects children. The occurrence rate of this disorder is less in children than adults, but if there is a family history of psoriasis, then a particular child may be more susceptible. It is very important for nail technicians to be aware of nail psoriasis, because all too often it is misdiagnosed as a fungal infection. Common signs of this disorder include little dents on the surface of the nail (pits) and separation of the nail plate from the nail bed. In addition, the nail bed may become very thick and have an orange color known as an “oil spot.” The most effective treatment for nail psoriasis is some form of cortisone. In children, we use cortisone creams predominantly, but in adults, cortisone injections around the nails have been very helpful. Physical injury or trauma to the nails may make the psoriasis worse, so remind your clients with nail psoriasis to be extra careful.

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