In the article, we will consider why the nail on the hand tears.
This pathological condition in medical science is 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 adhere 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 the genesis, the nail changes color, becomes cloudy, becomes layered and rough. The disease is diagnosed clinically, it is mandatory to carry out scraping from the lesion for fungi, the exclusion of somatic pathologies is required. When the nail on the hand bursts, the treatment of this condition is long-term, and may include sanitation of the focus of chronic infection, taking vitamin complexes and prescribing minerals containingfunds.
So, onycholysis is the distal detachment of the nail plate from the bed. The pathological process develops on one toe or hand or affects several fingers at the same time. In about 60% of cases, the disease is the result of traumatic damage to the nail, in 30% it occurs due to chronic ringworm. The remaining 10 are systemic somatic pathologies, pyoderma and dermatosis.
The situation in which the nail on the hand tears can happen at any age, is most often diagnosed in women, which many experts associate with professional nail care. The disease does not have seasonal and racial differences and is not endemic. The relevance of this problem is determined by the aesthetic factor that negatively affects the quality of life.
Causes of onycholysis
The reasons that can provoke the development of onycholysis can be divided into three categories: mycosis, trauma and allergies. The principle of the occurrence of the pathological process differs depending on the etiology.
It happens that a fingernail comes off after a bruise.
Traumatic detachment of the nail
When injured, both the nail bed and the nail itself are involved in the pathological process. Between them, a subungual hematoma is formed, in the structures of the dermis, mechanical compression of small vessels that feed the nail occurs, after which its nutrition is disturbed, elasticity and chemical composition change. Nailed nail begins to deform. Due to disruption of the trophic process of collagenligaments 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 a detachment, the higher the likelihood of a secondary infection with the onset of inflammation. At the same time, the connection of the plate with the matrix is not interrupted, 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 with a door or drop a heavy object on it. If the nail on the hand tears, it is immediately visible, because a hematoma immediately forms under it.
Infectious causes of pathology
The infectious type of onycholysis is based on an inflammatory process that goes through three main stages: alteration, exudation and proliferation. At the initial stage, pathological damage to the skin occurs, the cells of the reticuloendothelial and immune systems of the skin begin to produce cytokines and inflammatory mediators. After that, the process of blood supply to the nail is disrupted, trophism suffers, the structure of the plate changes.
The stage of exudation exacerbates all of the above disorders, and entails a change in water and electrolyte balance. In this case, swelling of the nail is observed, it becomes vulnerable to pathogenic bacterial flora and fungi that penetrate into 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 moreharmful microbes is involved in the development of the pathological process, the more intense the exfoliation. When it breaks 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 occurrence 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 occurrence of the disease
Allergic onycholysis is largely identical to inflammatory, however, 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 hypersensitization of the skin, enhances the processes of 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, several types of onycholysis are distinguished in dermatology:
- 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 long-term dermatoses with impaired trophism in the affected area.
- Systemic, which develops with a diseasedigestive 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. May be the result of a prolonged mycotic infection with foci of secondary onycholysis.
- Bacterial, resulting from infection.
- Allergic, which develops against the background of taking medications that have photosensitizing properties, in contact with UV radiation, chemicals.
How symptoms appear when a fingernail tears off.
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 hole. Visually, there is a change in the color of the nail from flesh to white, whitish-gray, which is due to the penetration of air into the subungual spaces. If microbes get in 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 - Pseudomonas aeruginosa 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, and an unpleasant odor occurs. Possibility of foci formationsecondary type of disease. If only part of the nail peels off, this indicates the development of partial onycholysis, but if the entire nail undergoes the process, they speak of a total view.
External signs of possible diseases
If the nail turned black after a bruise, then this phenomenon is characterized by the fact that during the injury, the blood vessels under the nail were damaged, and a hemorrhage occurred. This looks like a blackening of the nail at its base and subsequent detachment of the nail plate.
White nails that peel off may be a sign of bacterial onycholysis.
If the area around the ungual abscesses, this is a direct evidence of infection in this area, which provoked a purulent process.
Why do my fingernails crack?
Sometimes there is a phenomenon in which the nail plate cracks along. A crack can form as a result of trauma or some other reason. These include:
- effect of chemicals (e.g. household chemicals);
- prolonged contact with water;
- change temperature;
- contact with harmful chemicals used in repairs (paint, glue, etc.);
- wrong care;
- poor quality nail products;
- fungal diseases;
- dermatological pathologies;
- diabetes mellitus;
- fluid deficiency in the body;
- hormonal disorders;
- lack of vitamins and minerals;
- liver disease ordigestive organs.
Diagnosis
In most cases, if the nail on the hand comes off or turns black, the diagnosis is not difficult for dermatologists. Preceding this disease, nail damage with Bo lines is a valuable diagnostic sign, indicating either a systematic injury to the nail plate, or a periodic stoppage of its growth against the background of the progression of somatic pathologies.
Bo's lines - defects in the nail plate in the form of transverse depressions resulting from damage to the growth zone. In modern dermatology, it is believed that transverse lines are the result of trophic disorders of the nail matrix, which change the chemical composition of the plate. Given that it grows in about 90 days, the distance from the Bo line to the nail fold can determine the moment of injury or the duration of the chronic pathology that provoked the appearance of white nails.
The presence of detachment on several or one toe or hand nails and the determination of the possible causes of this phenomenon allow us to make a clinical diagnosis with a significant variety of the pathomorphological picture of this disease (changes in structure, color, transparency, hyperkeratotic layers differing in area and depth).
In addition, the obligatory diagnostic plan, when the nail leaves, includes scraping for fungi to exclude the possibility of mycotic nail damage.
Onycholysis is differentiated from psoriasis, fungal infections, lichen planus,Bowen's disease and onychodystrophies of unknown etiology.
Treatment
Therapy of this pathological process is usually 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 detachment of the nails was not an injury.
The main thing to do is, if possible, eliminate the underlying disease that caused onycholysis. In 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 case of traumatic onycholysis with detachment of a small area of the nail plate, the exfoliated area is cut daily with disinfection and protection of the nail bed with an antibacterial patch.
A large detachment is treated surgically, dressings are applied with antiseptic and antibacterial solutions. During the operation, hematomas, hyperkeratotic layers and dirt are removed. The nail is restored with the help of long-term use of gelatin solutions of different concentrations.
With onycholysis of mycotic or bacterial nature of origin, alcohol solutions of aniline dyes, antimycotic and antibacterial medicines are additionally used. Patients with onycholysis are shown to take vitamins, calcium and iron supplements, and tonic drugs. Excessive contact is contraindicatedwith water, household chemicals and cosmetic varnishes. The prognosis of the disease is relatively favorable, taking into account possible cosmetic defects.
So, tears off the fingernail, what to do?
General set of events
The set of therapeutic measures for detachment of the nail plate should be as follows:
- taking vitamin complexes;
- use of various ointments - antibacterial and antifungal;
- use of baths with antiseptics and decoction of medicinal herbs;
- lotions with antiseptics.
In addition, if a fingernail comes off, it is recommended to take the following measures to prevent recurrence:
- avoid injury;
- change socks more often (if the disease was observed on toenails);
- keep hygiene;
- don't keep hands and feet damp.
Folk methods
You can also treat nails with the help of folk recipes:
- Vinegar baths. Pour 9% vinegar into warm water and steam your hands or feet for 20 minutes, then wipe dry. Vinegar is also used for nail lotions.
- Tubes with tea tree oil. Pour hot water into a bowl, add 20 drops of oil, keep your nails in the water for 20 minutes.
- Using 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 methodtherapy, in which the usual application of an alcohol solution of iodine to the nails with a cotton swab is sufficient.
