In the article, we will consider why the nail on the hand is teary.
This pathological condition in medical science is usually called "onycholysis." A common type of acquired onychodystrophy, which is characterized by a violation of the connection between the nail bed and the nail while maintaining the matrix. This phenomenon is clinically manifested by the inability of the nail plate to grow to the nail bed during its separation from the distal edge.
With onycholysis of non-infectious origin, the nail plate does not change color and consistency. With a lesion caused by an infection of genesis, the nail changes color, becomes cloudy, becomes layered and rough. The disease is diagnosed clinically, scraping from the lesion to fungi is mandatory, the exclusion of somatic pathologies is required. When a fingernail bursts, the treatment of this condition is lengthy, and may include the rehabilitation of a focus of chronic infection, taking vitamin complexes and prescribing minerals containing drugs.
So, onycholysis is a distal exfoliation of the nail plate from the bed. The pathological process develops on one finger of the feet or hands or affects several fingers at the same time. In approximately 60% of cases, the disease is the result of traumatic damage to the nail, in 30% it occurs due to chronic dermatomycosis. The remaining 10 are systemic somatic pathologies, pyoderma and dermatosis.
A situation in which a fingernail tears on the arm can occur at any age is most often diagnosed in women, which many experts associate with professional nail care. The disease does not and does not possess endemicity of seasonal and racial differences. The relevance of this problem is determined by an aesthetic factor that negatively affects the quality of life.
Causes of Onycholysis
The causes that can provoke the development of onycholysis can be divided into three categories: mycosis, trauma and allergy. The principle of the occurrence of the pathological process differs depending on the etiology.
It happens that the nail on the hand comes off after a bruise.
Traumatic nail detachment
When injured, the nail bed and the nail itself are involved in the pathological process. A subungual hematoma is formed between them, mechanical compression of the small vessels that feed the nail occurs in the structures of the dermis, after which its nutrition is disrupted, the elasticity and chemical composition change. The nailed nail begins to deform. Due to the violation of the trophic process of collagen ligaments that fix the nail plate to the nail bed, the connection between the nail and the bed weakens, it begins to move away from the free edge. The larger the area of such exfoliation, the higher the likelihood of a secondary infection joining with the occurrence of inflammation. In this case, the connection of the plate with the matrix does not break, after the restoration of tissue trophism and resorption of the hematoma, the nail begins to grow in the same way as before.
This pathological phenomenon is often observed after a severe bruise of the nail, for example, if you press your finger against the door or drop a heavy object on it. If the nail on the arm is tearing, this is immediately visible, since a hematoma immediately forms under it.
Infectious causes of pathology
The infectious type of onycholysis is based on the inflammatory process, which goes through three main stages: alteration, exudation and proliferation. At the initial stage, pathological damage to the skin occurs, cells of the reticuloendothelial and immune systems of the skin begin to produce cytokines and inflammatory mediators. After this, the process of blood supply to the nail is disrupted, trophism suffers, the structure of the plate changes.
The stage of exudation aggravates all of the listed disorders, and entails a change in the water-electrolyte balance. In this case, nail swelling is observed, it becomes vulnerable to pathogenic bacterial flora and fungi that penetrate the intercellular layers of the nail. The defeat of the lower part of the plate and the nail bed begins, the nail is separated from the bed.
The more harmful microbes are involved in the development of the pathological process, the more intensive the exfoliation. When digging a fingernail, it is very unpleasant. Phagocytes and T-lymphocytes destroy foreign antigens, stimulate the proliferation process - the final stage of inflammation, which leads to the appearance of hyperkeratosis of the nail bed, its deformation. At the same time, hyperkeratotic growth of the nail plate begins, designed to restore the resulting defect. Normal nail growth can be observed after the complete elimination of the inflammatory process.
Allergic nature of the disease
Allergic onycholysis is largely identical to inflammatory, but at the stage of exudation, the reaction of excessive production of antibodies to pathogenic microbes that have invaded the nail and dermis predominates, which contributes to hypersensitivity of the skin, enhances the deformation of the nail plate and dermis, and slows down the regeneration process.
Classification
To prescribe adequate treatment, taking into account the heterogeneity of the disease in dermatology, several types of onycholysis are distinguished:
- Traumatic, which occurs as a result of damage to the subungual space or nail due to burns, wounds, splinters, physical or chemical influences, prolonged exposure to water or when wearing tight shoes.
- Dermatological, which is considered a consequence of prolonged dermatoses with a violation of trophism in the affected area.
- Systemic, which develops with a disease of the digestive system and metabolic disorders.
- Endocrine, formed on the background of endocrine and humoral disorders.
- Fungal, which is a consequence of the formation of bacterial colonies in the subungual space, a violation of the structure of the nail bed while maintaining a normal nail plate. It may be the result of a prolonged mycotic infection with foci of secondary onycholysis.
- Bacterial that occurs when an infection is attached.
- Allergic, which develops on the background of taking medications with photosensitizing properties in contact with ultraviolet radiation, chemicals.
How are the symptoms manifested when the nail on the arm is teary?
Symptoms
The clinical picture is typical and is characterized by detachment of the nail plate from the bed from the free edge in the lateral or distal sections to the nail socket. Visually there is a change in the color of the nail from body to white, whitish-gray, which is due to the penetration of air into the subungual spaces. If microbes enter instead of air, the color of the nail changes. Under the influence of bacteria, the nail becomes yellow, fungi give it a brownish tint, and greenish - a Pseudomonas infection. With microbial damage to the nail plate, its consistency also changes, it begins to deform and becomes rough.
In the space between the nail bed and the nail, keratin and dirt accumulate, subungual hyperkeratosis is formed, an unpleasant odor arises. The formation of foci of a secondary type of disease is possible. If only a part of the nail comes off, this indicates the development of partial onycholysis, but if the whole nail is exposed to the process, they speak of a total form.
External signs of possible diseases
If the nail turned black after a bruise, then this phenomenon is characterized by the fact that blood vessels were damaged under the nail and a hemorrhage occurred. It looks like blackening of the nail at its base and subsequent peeling of the nail plate.
White nails that exfoliate may be a sign of bacterial onycholysis.
If the periungual zone breaks, this is direct evidence of infection in this area, which provoked a purulent process.
Why do fingernails crack?
Sometimes a phenomenon is observed in which the nail plate cracks along. A crack may result from injury or some other cause. These include:
- the effects of chemicals (e.g. household chemicals);
- prolonged contact with water;
- change in temperature;
- contact with harmful chemicals used for repairs (paints, glue, etc.);
- improper care;
- low-quality nail products;
- fungal diseases;
- dermatological pathologies;
- diabetes;
- lack of fluid in the body;
- hormonal disorders;
- lack of vitamins and minerals;
- diseases of the liver or digestive organs.
Diagnostics
In most cases, if the nail on the arm moves away or blackens, the diagnosis does not cause difficulties for dermatologists. The damage to the nails by Bo lines preceding this disease is a valuable diagnostic sign, indicating either a systematic injury to the nail plate, or a periodic stop of its growth against the background of progression of somatic pathologies.
Lines Bo - defects of the nail plate in the form of transverse recesses resulting from damage to the growth zone. In modern dermatology, it is believed that the transverse lines are a consequence of trophic disorders of the nail matrix, changing the chemical composition of the plate. Given that it grows in about 90 days, from the distance from the Bo line to the nail roller, you can determine the moment of injury or the duration of chronic pathology that triggered the appearance of white nails.
The presence of exfoliation on several or one of the nails of the toes or hands and the determination of the possible causes of this phenomenon allow us to make a clinical diagnosis with a significant diversity of the pathomorphological picture of this disease (changes in structure, color, transparency, hyperkeratotic layers varying in area and depth).
In addition, the mandatory diagnostic plan, when the fingernail leaves, includes scraping for fungi to exclude the likelihood of mycotic lesions of the nail.
Onycholysis is differentiated with psoriasis, mycoses, lichen planus, Bowen's disease and onychodystrophies of unknown etiology.
Treatment
Therapy of this pathological process, as a rule, is complex. It involves the treatment of nails on the hands and, at the same time, on the legs, but only if the cause of the peeling of the nails was not an injury.
The main thing to do is to eliminate, if possible, the underlying disease that caused the onycholysis. With the dosage form of the disease, it is recommended to correct the activity of the digestive system with the help of a gastroenterologist, since detachment of the nail can occur due to a lack of vitamins and minerals, without which normal nail growth is impossible.
In traumatic onycholysis with exfoliation of a small area of the nail plate, daily exfoliation of the exfoliated zone is carried out with disinfection and protection of the nail bed by means of an antibacterial patch.
Large area exfoliation is treated surgically, dressings with antiseptic and antibacterial solutions are applied. During the operation, hematomas, hyperkeratotic layers and dirt are removed. Nails are restored using long-term use of gelatin solutions of different concentrations.
In the onycholysis of a mycotic or bacterial nature of origin, alcohol solutions of aniline dyes, antimycotic and antibacterial drugs are additionally used. Patients with onycholysis are shown taking vitamins, calcium and iron preparations, fortifying drugs. Excessive contact with water, household chemicals and cosmetic varnishes is contraindicated. The prognosis of the disease is relatively favorable, taking into account possible cosmetic defects.
So, the nail on the hand is tearing, what should I do?
Common set of activities
The set of therapeutic measures for exfoliation of the nail plate should be as follows:
- intake of vitamin complexes;
- the use of various ointments - antibacterial and antifungal;
- the use of baths with antiseptics and a decoction of medicinal herbs;
- lotions with antiseptics.
In addition, if the nail on the arm goes away, it is recommended to adhere to the following measures to prevent relapse:
- avoid injuries;
- change socks more often (if the disease was observed on the toenails);
- observe hygiene;
- Do not keep arms and legs damp.
Folk methods
You can also treat nails with the help of folk recipes:
- Acetic baths. Pour 9% vinegar into warm water and steam your hands or feet for 20 minutes, then wipe dry. Vinegar is also used for lotions to the nails.
- Baths with tea tree oil. Pour hot water into the basin, add 20 drops of oil, keep your nails in water for 20 minutes.
- The use of hydrogen peroxide. Wrap the steamed nails with a swab dipped in peroxide and secure with plastic wrap. Keep the lotion for an hour, then rinse the nail with water.
- Iodine treatment. This is the simplest method of therapy, in which the usual application of an alcoholic solution of iodine on the nails with a cotton swab is sufficient.