Thickened (Thick) and Rough Fingernails and Toenails Disorders

Thick Nails

  • Age-related thickness of the nail may be seen with age, along with other features like longitudinal ridges. These changes may not be abnormal but causative diseases need to be excluded.
  • Onychogryphosis is the malalignment (“crooked”) and thickened toenail often as a result of poorly fitting shoes. Ingrown toenails are a common problem as well. Other causes include age, trauma and psoriasis.
  • Pachyonychia congenita is a rare genetic disorder which affects keratin production. It appears as very thick and discolored nails. These signs are present from birth.
  • Thickening of the nails (onychauxis) without deformity may also occur as a result of a number of other causes which includes :
    • Psoriasis
    • Eczema
    • Dermatophyte (fungal) infection (onychomycosis) – has a typical yellow discoloration
    • Peripheral vascular disease
    • Yellow nail syndrome
  • Thickening of the finger, particularly the tip, may be related to clubbing.

Rough Nails

  • Trachyonychia is a fine roughness and white discoloration of the nail plate. It is also known as twenty-nail dystrophy because it involves all 20 nails on the body. Longitudinal ridges, pits, curved nails and a loss of luster may also be noticed. Causes include :
    • Lichen planus
    • Psoriasis
    • Eczema
    • Severe alopecia areata
  • Other causes of rough nails include :
  • Thickening at the tip of the nails may be seen with splinter hemorrhages, red to brown lines.

Nail Beading

Beading changes the smooth curvature of the nails with longitudinal striations that end as bumps at the tip, similar to dripping candle wax. Nail beading may occur with age or could be related to the following conditions :

  • Rheumatoid arthritis
  • Diabetes mellitus
  • Thyroid disorders
  • Addison’s disease
  • Vitamin B deficiency

Nails Lifting at the Tip

Onycholysis is the separation of the nail plate from the underlying bed at the tip of the finger or toe. Injury to the finger or toe is one of the more common causes but it may associated with other disorders like :

  • Psoriasis
  • Eczema
  • Drugs like tetracycline
  • Chemical exposure like strong detergents and solvents
  • Autoimmune diseases
  • Thyrotoxicosis

Onycholysis, like most nail defects, should not be considered in isolation to identify a possible cause of nail changes. Ridges, lines, pitting, change in curvature, discoloration, thickening and rough nails should also be considered.

Refer to the article on Fingernail Ridges for more information and pictures on :

  • Healthy Fingernails
  • Normal Lines and Ridges on the Fingernails
  • Inflamed or Swollen Nail Fold
  • Ridges and Furrows (Grooves) on the Nails
  • Curved and Pitting Nails
  • Digital Clubbing (clubbing of the fingers)

Refer to the article on Discolored Nails for more information on :

  • Change in Nail Colors
  • Colored Streaks, Lines and Spots on the Nails
  • Discoloration of the Nails

Related Articles

  1. Fingernail Ridges, Pits, Curved Nails – Health Problems, Pictures
  2. Discolored Nails – Causes of Spots, Lines, Streaks and Color Changes
  3. Parts of the Nail and Pictures – Human Finger and Toe

References

  1. Examining Fingernails. Emedicine
  2. Nail Diseases. Dermnet NZ