Scleroderma Types Systemic Symptoms Skin

Fingernails, Fingerprints, Nailfolds, and Cuticles

Overview

Hundreds of conditions can affect the fingernails. Dry or rough cuticles can be caused by many things, including frequent hand washing or lack of moisturizers. (Also see Skin Involvement, What is Scleroderma?, Types of Scleroderma and Systemic Symptoms)

The systemic forms of scleroderma can cause the fingernails to become smaller, and cuticles to become hard or rough. But because there are so many possible causes of poor fingernail or cuticle condition, they are not part of the diagnostic criteria for any form of scleroderma.

However, viewing the nailfolds under a microscope can disclose certain abnormalities of the small blood vessels, and specific findings can be very useful in diagnosing, classifying and staging forms of systemic scleroderma.

Unfortunately, in the U.S. such testing is frequently not covered by insurance companies, so there is widespread reluctance to do nailfold testing -- even though it is a very quick, easy, noninvasive, and economical way to diagnose and classify systemic forms of scleroderma. (Also see What is Scleroderma? and Symptoms of Scleroderma)

Cuticles: Periungual Erythema

The relation between periungual erythema and nailfold capillary abnormalities in patients with connective tissue diseases. Periungual erythema can be used for the detection of scleroderma spectrum disorders and dermatomyositis/polymyositis in clinical practice, although nailfold capillary microscopy is more accurate. European Journal of Dermatology.

Fingernail Abnormalities

Nail changes may be included in the American College of Rheumatology/European League Against Rheumatism classification criteria for SSc. (Also see Diagnosis of Scleroderma)

Nail involvement in systemic sclerosis (SSc). This study underlines that fingernail changes are correlated with more severe forms of SSc characterized by digital microangiopathy, including digital ulcers and calcinosis cutis. PubMed, J Am Acad Dermatol, 2017 Jun;76(6):1115-1123. (Also see Scleroderma Symptoms Checklist)

Nail Abnormalities. Just like the skin, the fingernails tell a lot about your health. Photos and descriptions of nail pitting, ridges, Beau's lines, leukonychia (white streaks or spots), koilonychia, and brittle nails. Medline Plus.

Causes of Fingernail Symptoms and Abnormalities

Causes of Nail Abnormalities There are many causes of fingernail or toenail abnormalities. NHS Choices.

Manicure Safety

It is particularly important for people with scleroderma and other illnesses to take good care of their fingernails and toenails, to ward off unnecessary complications. Use ample moisturizers, manicure nails weekly, and consult the doctor if you have troublesome nail symptoms.

How to keep your fingernails healthy and strong. Your nails may be small but they play an important role, serving to help protect your fingers and improve dexterity. They may also reveal clues to your general health. Mayo Clinic.

Fungal Infections of Fingernails and Toenails. A fingernail or toenail infection that is caused by a fungus is called onychomycosis (say: "on-ee-koh-my-ko-sis"). Toenails are more likely to become infected than fingernails. This infection can make your nails thick and discolored. Your nails may also be brittle or change their shape. FamilyDoctor.org.

Lack of Fingerprints

Scleroderma can cause sclerodactyly, a hardening of the fingers, which may cause vanishing fingerprints. (Also see:Sclerodactyly)

Did you know fingerprints can disappear? Vanishing fingerprints can be due to ilnesses such as eczema, psoriasis, or scleroderma. Sometimes it is caused by occupational damage, such as bricklaying. Accidents and intentional mutiliation can also erase, or change, fingerprints. (Also see What is Scleroderma?)

Marthie D: CREST Scleroderma. I have just applied for a new driver's license, for which fingerprints are taken. Eventually I had to get a doctor's letter to confirm that I have a skin problem and that the lines and cracks on my fingers are because of this. Now I have a driver's license card which states 'no prints'. (Does this mean I can perhaps have a new job? Shall we say, that of thief or any such one, seeing that I have no prints? Ha-ha!)…

Nail Biting

Nail biting: Does it cause long-term damage? Nail biting can worsen some existing conditions of the nail bed, such as infection of the skin around the nail bed (paronychia) or warts around the nail bed. In addition, you can pass bacteria or viruses from your nails and fingers to your mouth by biting your nails, making it more likely you'll catch a cold or other infection. Most nail biting is merely a bad habit that most people eventually break. But constant, severe nail biting can be a sign of anxiety or compulsive behavior. Mayo Clinic.

Nailfold Capillaroscopy

Nailfold Capillaroscopy is the best way to tell if someone has primary or seconday Raynaud's. Capillaries are very tiny blood vessels. Capillaries are very close to the surface of the skin, particularly near the base of fingernails. ISN.

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