The fingernails protect the ends of the fingers and function as tools that assist in fine motor functions such as picking up minute objects. Like other body parts, fingernails are vulnerable to diseases that may affect nail structure and function. Different nail diseases often cause similar signs and symptoms. An accurate diagnosis proves important in determining the appropriate treatment to restore fingernail health.
Paronychia
Inflammation or infection of the skin immediately surrounding the fingernail, or the nail folds, is termed paronychia. Acute paronychia usually develops after sustaining a small skin wound of the nail fold. Bacteria infect the wound, causing tenderness, redness and swelling. Pus may leak from under the nail fold. Dr. Dimitris Rigopoulos and colleagues report in a 2008 review article, "Acute and Chronic Paronychia" published by "American Family Physician," that the most common bacterial species responsible for acute paronychia include Staphylococcus aureus, Proteus vulgaris, Pseudomonas pyocyanea and group A streptococcus. Severe paronychia may lead to the formation of an abscess under the nail, which typically requires drainage. Nail loss may occur with large abscesses.
Chronic paronychia most commonly develops in people who frequently immerse their hands in water or other fluids, including janitors or cleaning aides, food handlers, laundry workers, chefs and nurses. Diabetics are also prone to develop chronic paronychia. Several fingers on one or both hands are usually involved, with the nail folds appearing swollen and red. The cuticle is notably absent around the affected nails, which may become discolored and misshapen over time. Fungi or, less commonly, bacteria may infect the affected nail folds, as noted by InteliHealth.com.
Onychomycosis
Fungal infections of the nails, or onychomycosis, affect approximately 12 percent of Americans, according to the American Academy of Dermatology. These infections tend to cluster in families, and most commonly occur in adults. A yellow or white area at the end of the fingernail is usually the first sign of infection. The infection spreads, progressively encompassing more of the nail. The affected nail often thickens, accompanied by a yellowish discoloration. Distortion of the nail shape and crumbling at the nail edge commonly occur. The fingernail may detach from the nail bed. MayoClinic.com notes that most fungal nail infections require treatment with an oral prescription medication such as itraconazole or terbinafine.
Psoriatic Nails
Psoriatic nails occur in approximately one-half of people with psoriasis, notes the American Academy of Dermatology on the patient information website PsoriasisNet.com. Mild to severe nail changes can occur. Nail pitting is a hallmark sign of psoriatic nails. The nail bed often appears yellow. The development of white spots often signifies impending detachment of the nail. In severe cases, the nails crumble and may be partially or completely lost. Several forms of topical and oral treatment are available, which can lead to significant improvements in many people with this fingernail disorder.
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