Mon, Jun 30, 2008
Mind Your Body, The Straits Times
>Q. I recently noticed some abnormalities in my elderly father's fingernails. The nails on both thumbs are separated from the flesh and they are white and opaque. There are some holes in one nail and a vertical line runs down from the tip of the other nail. Despite the nails' detachment from the flesh, he has no pain. He has not had any injuries to either thumb. Is this an infection or are there other health implications?
A. It is likely that he has a condition called onycholysis of the nails of both his thumbs. This happens when the nail plate separates from the nail bed.
There are various diseases that can give rise to this condition. One common possibility is a fungal infection called onychomycosis.
The opaque white appearance of his nails lends further credence to this although there are other conditions that can cause white nails.
However, your description of some holes on one nail may point to "pitting" which can be present in another disease called psoriasis where onycholysis is also a feature but there may be associated scaly rashes elsewhere.
Both these conditions may have a whitish crumbly debris underneath the nail plate and the involved nails may also be deformed.
Onychomycosis is a local disease of the nails and does not affect his general health. However, psoriasis is usually associated with scaly red rashes on the body and may also cause arthritis or joint inflammations.
Hence, it would be advisable to take him to a GP or dermatologist to have the diagnosis confirmed as well as to exclude other less common diseases that are not mentioned.
Information provided by Dr Goh Chyen Chye, a family physician at My Family Clinic of Alliance Healthcare Group.
This article was first published in Mind Your Body, The Straits Times on June 25, 2008.
