Nail Pigmentation

The nail plate is a semi-transparent keratinous structure and is not normally pigmented. It may appear discolored because of pigment on top of the nail plate, within the nail plate or on top of the nail bed. The pigment may arise from the distal or proximal nail matrix.

Longitudinal melanocyhia is due to activation of melanocytes in the nail matrix. It is more common in darker-skinned individuals and may affect one or several nails. The band may occasionally extend across the entire nail (total melanonychia). Transverse melanonychia is rare.
There are various causes of longitudinal melanocychia.

  • Exogenous pigment e.g., silver nitrate, tobacco, henna
  • Ethnic pigmentation is known as Racial Melanonychia
  • Inflammatory skin disease (psoriasis, lichen planus)
  • Trauma (nail biting, friction from shoes, radiotherapy)
  • Infections (paronychia, onychomycosis especially when due to molds; pigmentation is nonmelanocytic)
  • Drug reactions (hydroxyurea, antiretrovirals, antimalarials, metals)
  • Endocrine disease (Addison disease, Cushing syndrome)
  • Nonmelanocytic tumors (squamous cell carcinoma in situ, onychomatricoma, myxoid cyst, viral warts)
  • Melanocytic naevus of nail matrix
  • Lentigo / benign melanocytic hyperplasia
  • Malignant melanoma

Nails grow slowly – about 1mm a month, taking months to reach the distal edge, and longitudinal melanonychia reflects melanin deposition rather than the site of its production.

Bunions

What are Bunions? A bunion—also called Hallux Valgus—is a bump that appears inside the foot, around the metatarsophalangeal (MTP) joint (near the big toe). This bump is actually a bone protruding towards the inside of the big foot. Left untreated, bunions can cause sever pain and even hinder walking abilities. Bunions are a common problem … Read more

Diabetic Foot Care

People with diabetes are much more likely to suffer nerve damage, circulation problems, and infections—all problems that directly affect the feet. The lack of feeling and poor blood flow caused by poor diabetes management can allow a small blister or wound to progress into a serious infection that could lead to amputation. Nerve damage—also called … Read more

Heel Spurs

What is a Heel Spur? A heel spur is calcium deposit located underneath the heel that causes small pieces of bone to protrude. Pain associated with heel spurs is often confused with another condition called plantar fasciitis—which refers to inflammation in plantar fascia ligament. A heel spur, on the other hand, is a piece of … Read more

Ingrown Toenails

An ingrown toenail—also referred to as onychocryptosis—is a common problem that occurs when the edges or corners of the nail grow into the skin next to the nail. When this happens, the edge of the nail breaks through the skin, which causes inflammation. This inflammation initially presents itself as a minor discomfort, but it could … Read more