Nail Disorders in Children

Erin L. Luxenberg; Robert A. Silverman


Dermatology Nursing. 2010;22(1) 

In This Article

Nail Anatomy

The nail plate originates from the matrix that is located under the proximal nail fold. It is composed of keratin, very little water, and an even smaller amount of lipid. The proliferating epithelial cells in the proximal matrix are pushed forward to make up the top of the nail plate (de Berker, André, & Baran, 2007). The distal edge of the matrix is called the lunula; it produces the ventral surface of the nail plate (see Figure 1). Located under the nail plate is the nail bed. The nail bed comprises a thin layer of cells that produce distinctive keratins that interface with the nail plate. The interface of the nail plate and nail bed has a regular, longitudinal, and rugated configuration that gives the undersurface of the plate a tongue and groove appearance. Situated in a longitudinal and parallel arrangement in the connective tissue under the nail bed is the capillary blood supply to the nail.

Figure 1.

Anatomy of the nail

Nail folds aid in maintaining the direction of nail growth. The two lateral nail folds keep the nail centered while the proximal nail fold forms the cuticle, made from the horny layer of epidermis from the underside of the proximal nail fold. The onychodermal band refers to the interface that separates the nail bed from the dermal tip of the digit (Haneke, 2006).


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