Nails seem to have stopped growing at the matrix - advice needed

[Sassy Hassy]

Had a client in today for a facial, however she showed me her nails and I have to say I've never seen the like - not in life, or in a text book. The nails are still growing forward, however as they leave the matrix and are now in the lunula area the nail is totally unattached (although the rest is totally attached to the nail bed other than this bit at the proximal fold) and it appears that there is no new nail growing forward from the matrix behind it. If you feel what is there it is very soft tissue indeed, more like skin than nail.

The client had a severe reaction to antibiotics causing her to break out in a skin disorder of red bumps and blotches which is now starting to fade. If you look at the estimated time of nail growth to where it is now it seems to coincide with the antibiotics.

I have taken pics but for some reason I cannot upload them so will try again tonight. But I told her I'd come and ask if anyone knows what the condition may be, she doesnt want to go back to her doctor if she can help it as she is sick of seeing him in the last few months. Poor lady is very down at the moment.

any help would be great, particularly a prognosis. :hug:

 

[user 17597]

My daughter, who is nearly two, has this problem on both her big toenails. the nail is seperate from the new growth. Not exactly the same as your client, but the same in that her nail grows along the nailbed but is not attached to the matrix, but with her, a new nail starts to grow. Her consultant believes this to be cell deficiency, but it is still to be investigated further.
Going by that, i would hazard a guess that her antibiotics some how played havoc with certain cell mitosis and so the nail continued to grow but there was no new nail behind it. Hopefully if this is the case then once the antibiotics are completely out of her system and the cells have had time to repair, then she should see new nail growth.
Not much help sorry, but thought id reply as it is similar to my daughters problem.
Also where my daughters nail is not attached to the matrix as it gets near the smile line it starts to lift and come away, so your client will most probally experience this too. Hopefully some nail has grown by then.

 

[Sassy Hassy]

Cheers hun, I have a feeling it is the antibiotics that have caused this. Just wondered if it had a medical name like onycho-wotsit. I told her to go to her docs but she is so depressed and said she couldn't face going again! I guess the only think to suggest is the usual lashings of solar oil!!!

 

[Artsy Canadian]

you can search around on this very informative page.....it's a long shot but you could possibly find what your looking for...
NZ DermNet site map. DermNet NZ

 

[Sassy Hassy]

you can search around on this very informative page.....it's a long shot but you could possibly find what your looking for...
NZ DermNet site map. DermNet NZ

OMG I love you, I had that in my favourites, but lost it. It is such a fab site MWAH :Grope::hug:

Edit - ewww I forgot how gross some of those pics are! But none come close to what she has. So just hoping that the matrix isn't permanently damaged and that her nails do grow forward again.

 

[Classy Claws]

I wouldnt suggest a Dr, if there is no improvement go see a Foot Dr, umm what do u guys call them over there Chiro/pod? they specialise in the feet and have a WEALTH of knowledge when it comes to the nails, normal General Practitioners know a little about a lot, which is not nearly enough when it comes to nails.

an example, I had a lady come to me for help, she had gone to the dr with this yellow band across her thumb, Dr noted she smoked and told her it was just a nicotine stain, by the time she had saught help else where (me) she had a full blown bacterial infection, & black nail that was barely holding on to any nail bed at all.

 

[Sassy Hassy]

Hiya! Funnily enough I always recommend clients to go to a podiatrist rather than a doctor for nail probs. She has been seeing a dermatologist and i asked if she'd mentioned it to him (sorry I did say doc earlier). She said she'd had enough of doctors and I totally forgot about the podiatrist. I'll suggest it to her, but I have a feeling she won't want to go (there's no helping some people I know!)

I guess as well that my professional curiosity has gotten the better of me and I just want and NEED to know what it is. It's defo a trauma of some kind and I'm sure it's caused by the meds! Just wish i could get my darend camera to upload onto the pc - modern technology can be such a bind at time!

 

[Classy Claws]

Just wish i could get my darend camera to upload onto the pc - modern technology can be such a bind at time!

*shakes sassys camera*

I wanna see lol

I have a file on my computer to do with nail disorders, it contains at least a dozen very high resolution pictures of each nail disorder (it takes up about 8gig on my hard drive lol) I will go have a wander thru and see if I can find anything similar to what you describe.

 

[Sassy Hassy]

okay here's the pics, hope it helps

 

[VillageNails]

sassy - just a thought - has she swollen joints also?? is she on any other meds that might have caused the nail probs?

 

[Sassy Hassy]

OMG now I'm trying to remember my consultation (yes the one that my colleague today tells me I take too long and ask too many questions - sore point as you can prob tell!).

Okay she is on meds for high blood pressure and has back probs (arthritis) but I think she sees a physio rather than taking tablets for it, and on meds for her nerves too. The nails are only a prob in the last couple of months and it seems to coincide with the reaction she had with the antibiotics more than anything else.

 

[fificharlie]

A stab in the dark here -

Could it be that her skin condition was psoriasis? Bought on by illness of some kind, or a lowered immune system? - maybe a coincidence that the reaction showed at the same time as taking antibiotics? hmmm....

The only reason I say this is because the nails look quite brittle, with ridges - I know psoriasis of the nails usually shows itself as 'pitting' of the nail plate - but I had a client with psoriasis of the skin and her nails looked very similar to your client's.

It certainly looks like the nails have literally stopped growing - which I understand can happen at times of severe illness.

I cant really see the pics in great detail as I dont have the best screen in the world, but the index fingernail in the second pic almost looks pitted?

Like I say, a wild stab in the dark! :hug:

 

[mum]

Hi Sass

Poor lady! This is def a systemic problem. It could be as a result of her cocktail of medication. It could be the blood pressure problem. It could be an arthritis problem.

Whatever it is, it looks like she is either shedding her nails or has an interruption in the natural nail growth from the matrix.

I think she needs to get medical advice (she is obviously continuously in touch with medical help). It would be easy to make this condition look better but that would hide what is actually going on and I think this needs to be apparent for now.

As much as you would like to make it better for her, I think you should stand back right now and see what happens.

Wish her well

xx

 

[Classy Claws]

FOUND IT!!!! (god I love my medical books *hugs them*)

ONYCHOMADESIS / NAIL DYSTROPHY

"A large number of drugs may be responsible for the development of nail changes, including cancer chemotherapeutic agents and retinoids, however, only a few classes of drugs are consistently associated with nail symptoms (including alot of common anti-biotics). Drug-induced nail abnormalities result from toxicity to the matrix, the nail bed, the periungual tissues or the digit blood vessels. The most common symptoms include Beau’s lines, onychomadesis, melanonychia, onycholysis and periungual pyogenic granulomas. Drug-induced nail changes usually involve several or all of the nails. In most cases, nail abnormalities are asymptomatic, but can sometimes cause pain and impair manual activities."

"Onychomadesis refers to the spontaneous separation of the nail plate from the matrix area and is associated with arrest of nail growth."

I know hers arnt as bad as the first pic, but the toe pic is closest to your photo, I have also found it vairys quite a bit but is still the same condition

 

[oey]

I agree with Mum on this one - as it is on all her nails it could well be something that she has not yet been fully diagnosed with so I recommend that she gets more medical advice - even as you say from a foot doctor eek as they could possibly recognise the symptoms - and give her the correct line of treatment advice - then you can tell us all - cause I am very curious too now.

 

[lotus blossom]

Beaus Lines Nails

i was too slow!!
i
i also think this looks similar to what you are describing sass

 

[Sassy Hassy]

Hiya Classy Claws and thanks, that is exactly what she seems to have and I can now urge her that a trip to the docs, derm or podiatrist really is a must as Mum says to do. It's easier to encourage them to go when you have an inkling of what it is - I find when you just say I don't know go see a specialist they don't take you quite so seriously and don;t bother going.

Thank you all for your help, you guys are great.

BTW the ridging I would say is more down to dehydration and age, they defo aren't beau's lines cos I've seen them before, this I have never seen not even in a text book and I just needed to know from a nail tech's curiosity to learn.

Will report back if i can persuade her to go and see someone. At least I've tried to help her.

 

[angel fingers]

sassy, your description was good. when i saw your photos they were exactly as i had imagined.

i would be concerned about a bacterial infection taking hold on her nails . that little pocket where the nail has lifted would make a lovely comfy home for a bit of damp and pseudo.