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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