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ลักษณะโครงสร้างของเล็บ
   Nail Anatomy

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  เอคซีม่า
  Eczema

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  เชื้อไลเคนส
  Lichen planus
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  Internal Disease
 
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 ความผิดปกติของเล็บจาก เอคซีม่า Eczema      

Eczema
Nail rippling and nail plate distortion occurs with chronic paronychia or chronic eczematous inflammation of the proximaland and lateral nailfolds. The ripples of chronic inflammation appear as rounded waves, in contrast to the closely spaced, sharp grooves produced by continual manipulation. Pitting can also be created by chronic inflammation of the nail folds



 

 

 

 

 ความผิดปกติของเล็บจาก เชื้อไลเคนส์Lichen planus      

เชื้อไลเคนส์ Lichen planus
Approximately 25% of patients with nail lichen planus (LP) have LP in other sites before or after the onset of nail lesions. Nail LP usually appears during the fifth or sixth decade of life. The matrix, nail bed, and nailfolds may be involved in producing a variety of changes, few of which are characteristic.

Minimal inflammation of the matrix induces longitudinal grooving and ridging, which are the most common findings of LP of the nail. The development of severe and early destruction of the nail matrix with scarring characterizes a small subset of patients with nail LP.

A pterygium, caused by adhesion of a depressed proximal nailfold to the scarred matrix, may occur after intense matrix inflammation. The nail plate distal to this focus is either absent or thinned out. In most cases, nail LP is self-limiting or promptly regresses with treatment. Permanent damage to the nail is uncommon, even in patients with diffuse involvement of the matrix.

Treatment

Matrix lesions may respond to intralesional triamcinolone acetonide (2.5 to 5 mg/ml) delivered with a 30-gauge needle every 3 or 4 weeks. Severe cases respond to prednisone (20 to 40 mg/day). This may require a long course of treatment in which the possible risks may outnumber the advantages.





 

 

 

 

  ความผิดปกติของเล็บจากโรคอื่นๆที่มีผลต่อเล็บ  Internal Disease  

There are many internal diseases that can alter the appearance of the nail plate . Three of the most common diseases can be seen by pushing the buttons on the left.

Check this sight again for a table of all internal diseases affecting the nail plate and tables showing diseases that cause color changes of the nails.

 

 

Finger clubbing
Finger clubbing (Hippocratic nails) is a distinct feature associated with a number of diseases, but it may occur as a normal variant. The distal phalanges of the fingers and toes are enlarged to a rounded, bulbous shape. The nail enlarges and becomes curved, hard, and thickened. The angle made by the proximal nailfold and nail plate (Lovibondís angle) increases and approaches or exceeds 180 degrees. The proximal nailfold feels as though it is floating on the underlying tissue. Clubbing is associated with a variety of lung diseases, cardiovascular disease, cirrhosis, colitis, and thyroid disease. The changes are permanent.

 

 

Beau’s lines
Beau’s lines are transverse depressions of all of the nails that appear at the base of the lunula weeks after a stressful event has temporarily interrupted nail formation.The lines progress distally with normal nail growth and eventually disappear at the free edge. They develop in response to many diseases, such as syphilis, uncontrolled diabetes mellitus, myocarditis, peripheral vascular disease, and zinc deficiency, and to illness accompanied by high fevers, such as scarlet fever, measles, mumps, and pneumonia

 

 

Alopecia areata
Many patients with alopecia areata have shallow pitting or surface stippling in a uniform or grid like pattern . The pits are are of uniform depth, psoriatic pits are usually deeper and are haphazardly distributed on the nail plate surface




  


 






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