Nails appear to be unfixed in the skin. Can this issue be treated?

Hello,

Welcome to icliniq.com.

I saw the clinical picture (attachment removed to protect the patient's identity). It looks like twenty nail dystrophy. This is a clinical diagnosis. Some cases are genetic and some are acquired. The cause for the nail dystrophy is not very well known. Some of the systemic diseases like anemia, IgA deficiency, primary biliary cirrhosis are the mentioned causes. Some of the skin diseases like atopic dermatitis, alopecia areata, vitiligo, eczema are also known to cause this type of nail changes. This is not a fungal infection. Because all the finger and toenails are involved equally. Usually, fungal nail infection starts in one fingernail then spreads to few other nails, but never all nails. This is a difficult condition to treat, there are case reports saying spontaneous correction of nails with age.Other treatment modalities include:

1. Nail supplements, Biotin oral pills, at night.
2. Topical corticosteroids would help in the early stages.
3. Topical 5 FU has shown some promising results.
4. Topical Psoralen UVA (PUVA) therapy for nails.

A protein-rich diet consisting of eggs, chicken, milk, dal (lentil), and curd would help because nail is made up of protein. Dietary protein is very important. She can start taking nail nutrient pills, that has biotin, calcium, zinc, iron, etc.