Examining the Fingernails When Evaluating Presenting Symptoms in Elderly Patients

Mark E. Williams, MD

Disclosures

November 23, 2009

In This Article

Processes Around the Nail

Paronychial Inflammation

Paronychia is associated with separation of the seal between the proximal nail fold and the nail plate that provides entry for bacteria and leads to a localized infection of the paronychial tissues of the hands (Figure 29). Symptoms may include inflammation, swelling, and/or scaling.

Figure 29. Example chronic paronychial inflammation.

Periungal Telangeictasia

Periungal telangeictasia is caused by dilated capillary loops and results in atrophy of the cuticle (Figure 30). It is strongly associated with collagen vascular disease, including the following:

  • Systemic lupus erythematosus;

  • Dermatomyositis (especially with Gotton's papules over knuckles); and

  • Scleroderma.

Figure 30. Example of periungal telangeictasia. Image courtesy of www.dermnet.com Used with permission.

Mucus Cyst

A mucous or myxoid cyst is a collection of degenerative collagen that can cause swelling and ridging of the nail above the cyst, forming a "gutter" (Figure 31).

Figure 31. Example of a mucus cyst.

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