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What is Erythronychia and what causes it?

Erythronychia is something we see more often in the nail salon or podiatrist practice but don’t recognize – it is a general name for a group of nail problems that begin at the distal matrix of the nail unit

Erythronychia is a term that covers a range of pathological patterns of red discoloration of the subungual tissues. The intensity of the red contrasts with the pale pink of the nail bed, or the cream color of the lunula. It is typically due to one or more factors that include inflammation, vessel proliferation, engorgement, and focal thinning of the nail plate.

The pathological basis or the reason for it happening could be one of many things, and it is up to a medical specialist to make the call. 

We can divide the reasons into 3 groups

  • Dermal tumor (adjective-relating to the skin or dermis) pressure
    • Glumos Tumor (slow growing tumor, generally found in the nail bed but can be on the fingertip or somewhere in the toenail unit) 
    • Vascular Tumor (fast growing tumor formed from blood vessels or lymph vessels)
  • Matrix 
    • Epidermis disease 
      • Darlier Disease (a kind of keratosis)
      • Dysplasia (abnormal cell growth) 
      • Possible viral infection (or wart)
  • Nail plate with ventral groove
    • Nail bed swells into the nail plate grove with capillary engagement and hemorrhage
    • Thinned nail plate that disintegrates distally 
    • Exposed Distal nail bed 
    • Generating Multi nucleate giant cells (mutation, thickening) and protruding keratosis 

Who does it affect?


How can nail technicians help?

There is a contraindication for application for all artificial nail products until a medical practitioner has made a diagnosis. 
If the medical practitioner gives the green light, a nail technician can cosmetically correct it by applying a coating.
However, sometimes small surgeries are needed to correct the problem.

In this example, the blue arrows show an exposed distal nail bed with protruding keratosis. We also see possible alopecia dimples in the nail plate on the left (Yellow Arrows), and on the right, we see possible psoriasis dimples in the nail plate (Green Arrows) .
This example shows the nail bed swelling into the nail plate grove (blue arrows) with capillary engagement and hemorrhaging (yellow arrows), possibly caused by a virus infection, in this case, a wart. The pink arrows show the 2 roots of the wart (not diagnosed from the picture). This diagnosis was confirmed by this client’s dermatologist.
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