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Diabetic Exam
 
 

Nail Inspection

 
 
 
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Overview

Diabetics often exhibit onycholysis of the nails, and poor diabetic control can lead to increased infection risk and paronychias.

Onycholysis

  • Look For

  • Separation of the nail from the nail bed, either distally or laterally.
  • Causes of Onycholysis

  • Systemic disease - chronic kidney disease, bronchial carcinoma, anaemia, diabetes mellitus, porphyrias, peripheral vascular disease, thyrotoxicosis
  • Nail infection - fungal, bacterial
  • Skin disease - psoriasis, dermatitis, lichen planus
  • Trauma

Paronychia

  • Look For

  • Erythema and swelling of the skin around the fingernails, which may be associated with pus from the nail fold.
  • Significance

  • Infection, usually due to Staphylococcus, Streptoccocus or sometimes Herpes simplex.
  • Predisposing Factors

  • Ingrown nail
  • Artificial nails
  • Manicuring
  • Habitual nail biting
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