I think I Have a Fungus on my nails

I think I have a fungus on my nails. 

  The nail may be dystrophic and thick or it may have colored lines running through it. 

  Another presentation is with a white layer on the surface of the nail. Sometimes the problem is in the nail bed causing the nail to lift ( Onycholysis) but this picture is more often seen in nail bed psoriasis.

  Fungal infections may also start at the nail lateral edge. There are new topical antifungal nail preparations coming available which actually penetrate the nail and can give cure rates of 60-80%. Otherwise Terbinafine should be used orally 250 mgs daily for 12 weeks.

Consultations in Dermatology
 

My nails are thin, thick or breaking

My nails are thin, thick or breaking.

Thick Nails The main conditions are

Traumatic dystrophy with age - Minor recurrent traumas to the nail matrix eventually lead to a thickened misshapen nail. Vascular impairment also plays a part. Common in the elderly involving the little and big toes.

Psoriasis - Severe dystrophy in some cases. Associated with tendency to get psoriatic arthritis.

Nail Psoriasis

 

Tinea Unguium - Can look very psoriatic but varying colous of thickened keratin suggests fungus.

 

Rare = Pachyonychia Congenita Here all the finger and toe nails are grossly thickened with intra oral leukoplakia.

Pachyonychia congenita

Thin Nails

Essentially iron deficiency but that also causes cupping of the nail.

Easy breaking Nails

Lamellar splitting of the edges of nails occurs as an aging phenomenon plus excess water exposure.The nails layer split at the tip edges.  Use clear nail polish and keep your hands out of water.

Lamellar splitting of nails

I have bald areas in my scalp

 

I have bald areas in my scalp Alopecia areata - Sudden onset, bald discrete areas in scalp, Follicle openings still present, Any age group. Consultation Tinea capitis - scale and broken hairs still present. Variable redness.  Consultation Trichotillomania where a person pulls out hairs in their scalp. Usually children. Funny shape and broken hairs. See this case Scarring alopecia - bald, smooth, no hair follicle openings on the surface, likely Lupus erythematosus or Lichen Planopilaris   Receding frontal hair line in menopausal female  -- Likely frontal fibrosing alopecia. Slowly receding frontal hair line with smooth hairless frontal forehead. Becoming a common disorder.   Consultation Rare - Aplasia cutis congenita, A bald area of the scalp present from birth. Sebaceous nevus     A bald area of the scalp present at birth thickening up at puberty. View the video of this topic