nails

Here are some things that concern parents about their children's finger and toenails.

A crush injury to a nailbed can result in a pocket of blood, often causing throbbing pain, under the nail. This is termed a subungual hematoma. It sometimes needs some minor medical attention to painlessly drain the blood collection.

An infection around the bed of the nail which appears as a bulging pocket of pus about the margin of the nail is a paronychia.

Bacterial infection under the nail can lead to separation of the nail from the nail bed and eventual shedding.

Ingrown toenails are most common in adolescents. Ingrown toenails almost always are those of the great toes. They usually begin with picking and tearing at the great toenail, and end with a swollen, excruciatingly painful toe. Careful trimming, warm soaks, and sometimes oral antibiotics are the treatment; proper nail care counsel is the prevention. Podiatry referral for surgical excision may be necessary for ingrown nails that do not respond to conservative primary care treatments.

Conditions that may require a dermatologist

Many nail conditions are best diagnosed and managed by a dermatologist, both for diagnostic accuracy and because treatment of some nail conditions may involve medications that primary care physicians are not experienced in using.

A buildup of crumbly debris under a nail, more often a toenail, is a fungal or yeast infection termed onychomycosis.

Previously normal nails that appear thickened and deformed may reveal a fungal infection of the nail plate itself - tinea unguium.

Psoriasis may involve the nail plate, leaving it pitted and crumbly. The nail may separate from the nail bed and may also appear red, orange or brown, with red spots in the lunula (the whitish half-moon shaped area at the base of the nail).

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