NAIL STRUCTURE

The nail structure is divided into six parts: root, nail bed, nail plate, eponychium, paronychium, and hyponychium.
Each of these six components has a specific function, and if a component of the nail structure is disrupted, the
nail can look abnormal.

Nail root: The root of the nail is also known as the germinal matrix. Its edge appears as a white crescent, known
as the lunula. The root portion of this nail lies below the skin, underneath the nail, and extends several millimeters
into the finger. It produces most of the volume of the nail and the nail bed.

Nail bed: The nail bed is also referred to as the sterile matrix. It extends from the edge of the nail root, or lunula,
to the hyponychium. The nail bed contains blood vessels, nerves, and melanocytes that produce melanin. As the
root grows the nail, the nail streams down along the nail bed and adds material to the underside of the nail to
make it thicker. When the nail grows properly, the nail bed is smooth, but if the nail doesn't grow correctly, the
nail may split or develop ridges that aren't cosmetically attractive.

Nail plate: The nail plate is the actual fingernail, and it's made of translucent keratin. The pinkish appearance of
the nail comes from the blood vessels that are underneath it. The underside of the nail plate has grooves that run
along the length of the nail and help anchor it to the nail bed.

Eponychium: The eponychium is more commonly known as the cuticle. The cuticle is situated between the skin
of the finger and the nail plate. It fuses these structures together and provides a waterproof barrier.

Perionychium: The paronychium is the skin that overlaps onto the sides of the nail plate, also known as the
paronychial edge. The paronychium is the site of hangnails, ingrown nails, and paronychia, a skin infection.

Hyponychium: The hyponychium is the area between the free edge of the nail plate and the skin of the fingertip.
It also provides a waterproof barrier.
BEAU’S LINES
Depressions that run across your fingernail are called Beau’s lines. These can be a sign of
malnourishment. Other conditions that cause Beau’s lines are:
 diseases that cause a high fever such as measles, mumps, and scarlet fever
 peripheral vascular disease
 pneumonia
 uncontrolled diabetes
 zinc deficiency

CLUBBING
Clubbing is when your nails thicken and curve around your fingertips, a process that generally
takes years. This can be the result of low oxygen in the blood and is associated with:
 cardiovascular diseases
 inflammatory bowel disease
 liver diseases
 pulmonary diseases
 AIDS

KOILONYCHIA (SPOONING)
Koilonychia is when your fingernails have raised ridges and scoop outward, like spoons. It’s also
called “spooning.” Sometimes the nail is curved enough to hold a drop of liquid. Spooning can be
a sign that you have:
 iron deficiency anemia
 heart disease
 hemochromatosis, a liver disorder that causes too much iron to be absorbed from food
 lupus erythematosus, an autoimmune disorder that causes inflammation
 hypothyroidism
 Raynaud’s disease, a condition that limits your blood circulation

LEUKONYCHIA (WHITE SPOTS)

Nonuniform white spots or lines on the nail are called leukonychia. They’re usually the result of a
minor trauma and are harmless in healthy individuals. Sometimes leukonychia is associated with
poor health or nutritional deficiencies. Factors can include infectious, metabolic, or systemic
diseases as well as certain drugs.

MEES’ LINES
Mees’ lines are transverse white lines. This can be a sign of arsenic poisoning. If you have this
symptom, your doctor will take hair or tissue samples to check for arsenic in your body.
ONYCHOLYSIS
When the nail plate separates from the nail bed, it causes a white discoloration. This is called
onycholysis. This can be due to infection, trauma, or products used on the nails.

Other causes for onycholysis include:

 psoriasis
 thyroid disease

PITTING
Pitting refers to small depressions, or little pits, in the nail. It’s common in people who have
psoriasis, a skin condition that causes the skin to be dry, red, and irritated. Some systemic diseases
can also cause pitting.

TERRY’S NAILS
When the tip of each nail has a dark band, it’s called Terry’s nails. This is often due to aging, but
it can also be caused by:

 congestive heart failure

 diabetes
 liver disease

YELLOW NAIL SYNDROME

Yellow nail syndrome is when the nails get thicker and don’t grow as fast as normal. Sometimes
the nail lacks a cuticle and may even pull away from the nail bed. This can be the result of:

 internal malignancies
 lymphedema, swelling of the hands
 pleural effusions, fluid buildup between the lungs and chest cavity
 respiratory illnesses such as chronic bronchitis or sinusitis
 rheumatoid arthritis