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
Last updated on November 28th, 2019
 
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