Dark streaks in the toenails are common in the United States, especially in those with darker toes, especially African Americans. For the most part, these streaks generally represent non-serious conditions. However, especially in fair-skinned people, the presence of these streaks could represent a deadly cancer. This article will discuss common causes or dark streaks in the nails, and what condition is the cause of the alarm.
Before starting, the reader should be aware when reading this article that the information contained is not intended to provide medical advice specific to one's own medical condition, but is intended as a general discussion on this topic of health. Any specific questions or concerns regarding the conditions described in this article should be directed to your own general practitioner or specialist for proper diagnosis and treatment.
The nail is a dense tissue consisting of compressed keratin. The nail plate itself begins in the nail matrix, which is basically the root of the nail. The outer edge of the matrix is seen externally as the lunula, or the white semicircular area at the base of the nail just beyond the cuticle. The nail slowly grows outward, sliding semi-loose along the skin. The color of the nail itself is a kind of opaque white or cream, with some sharpness to see the skin underneath. The discolourations in the nail plate, whether they are white, yellow, blue, brown or black, are abnormal and represent a pathological process. The most common sources of discoloration of toenails are due to keratin debris accumulated under the nail due to natural thickening and aging of the nails, as well as fading caused by a fungal infection. These usually create a white, yellow or yellow-brown discoloration. Since these two long topics have been covered by this author in other articles, the causes of the darker shades of fading will be presented here.
Dark nail fading has several causes, and a proper diagnosis of the cause is the key to successful treatment. The most common reason why nails become dark is because of bruising under the nail. Bruising is essentially blood left behind by bleeding. It can occur under the skin, and can also occur under and on the top of the skin located directly under the nail. Bleeding under a fingernail can be caused by dropping a heavy object on the toe, by the pressure of tight shoes, by toes stuck in the end of the shoe as often in runners, and by injuries that cause the bursting of blood vessels. Spontaneous rarely if ever occurs, and often if one does not remember to hurt the toe, it usually means that the injury was minor enough not to cause an initial and memorable pain. The bruise under the nail remains in the nail plate until it develops with the nail.
Bruising that does not develop as the nail grows is a concern and a podiatrist should be contacted. The potential cause of this will be discussed later. When the bruise occupies less than a quarter or a third of the nail, it can probably be left alone and the nail can grow. If the bruise is more extensive, covering the entire surface of the nail, the nail plate should be removed. This is done for two reasons. First of all, it allows the blood to drain properly, and limits the amount of damage caused by bleeding to the root of the nail when it slightly raises the nail plate. during active bleeding. Second, the bleeding may have been caused by a deep cut of the skin under the nail plate during the initial injury, and this skin needs to be evaluated for any cuts that need to be sewn. Another concern, especially if a fracture has appeared in the bone under the nail, is the presence of bone pieces that penetrate the skin from the outside. If these are not removed and the skin is cleansed and treated properly, the infection can develop which can spread to the underlying bone.
Another cause of dark discoloration is infection. As previously discussed, the fungus can enter the skin under the nail and cause discoloration, thickening, brittleness and debris. This mushroom is the same in the same group of organisms that cause the athlete's foot, and from a point of view of color can change the opaque to white nail solid, yellow, gray, brown, or even black in some cases. The treatment is somewhat complex because only some drugs have scientifically proven efficacy, and there are still many home treatments that simply show no real value. Another source of infection comes from bacteria, especially bacteria from a family of organisms called Pseudomonas. This bacterium is prone to invade the skin that has been kept moist for a while, and is commonly prevalent in whirlpools and hot tubs. The bacterium creates a green color change in the skin and nail tissue, presumably from iron pigments. The so-called green nail syndrome is common, and is treated with a dilute solution of diluted vinegar (acetic acid), or with specific antibiotics targeted against pseudomonas. This infection rarely progresses to a more severe condition in healthy people, and is usually easy to treat.
Discoloration of the nails that moves across the width of the nail in a thin line from one side to the other side has many different causes to discuss many in detail. Causes may include kidney disorders, certain mineral deficiencies, toxic metal poisoning, heart disease, chemotherapy for cancer, certain chronic medications, and serious injuries to the body. Due to the wide variety of causes, a visit to a primary care physician, dermatologist or podiatrist is recommended. There is usually no immediate treatment for these lines, but the doctor can diagnose another condition requiring treatment by examining the fingernail, especially if metal intoxication or mineral deficiency does not occur. is not diagnosed.
Fading fingernails that moves from the beginning of the nail until the end is the only symptom that causes the most concern. This streak is typically brown, dark blue or black and can be found on one side of the nail or in the center. Usually, this streak takes less than a quarter of the width of the nail itself, although in some cases it may be wider. The usual cause of this streak is the overproduction of cells that produce skin pigmentation, otherwise known as melanocytes. These cells produce melanin, which gives people with dark skin their complexion, and Caucasians their tanned skin. It naturally protects the skin against the harmful ultraviolet rays of the sun, although overexposure to the sun can lead to a mutation in the production of melanocytes. This is technically a cancerous growth. In most cases of nail streaking and skin conditions such as moles, this is a benign growth. However, malignant cancer can develop and spread to other organs, resulting in death. This cancer is called melanoma, and it is deadly. Dark streaks starting at the cuticle and moving along the nail are very common in those with darker skin tones, especially African-Americans.
In fact, many people have streaks on almost all their nails, and have had them since birth. These usually do not represent melanoma of the nail, and are usually benign. When these streaks are newly developed in Caucasians, or if there is a new growth or a change in a pre-existing streak in someone with darker skin, the nail and the skin surrounding it Nail should be evaluated by a doctor. This is especially true if a skin discoloration next to the nail develops, regardless of the original tone of the skin. A biopsy of the streaked portion of the nail, the root of the nail and the surrounding area of the skin should be performed to ensure that there is no malignant cancer. It is a simple procedure, usually performed in a cabinet by a podiatrist, a dermatologist, or sometimes a general surgeon or family doctor, and it heals quickly. The nail generally regrows in good health if the condition was benign. If melanoma is present, immediate attention should be paid to the toe to prevent further spread. This usually includes amputation of the tip of the toe, or the toe in its entirety depending on the size of the melanoma. This is absolutely necessary to save his life and prevent the spread of cancer.
As can be seen, dark nail fading can have many different causes. Most are benign and resolve with simple treatment. Some are simply genetic, like common nail marks in dark skinned individuals. Others are dangerous cancers that require immediate treatment. Because of the potential for cancer, this author recommends that all areas of dark discoloration in the nails be evaluated by a doctor to ensure that the condition is benign. The less waste, it's a little time with the doctor, and at best one can save his life.