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Nails protect fingers and toes. According to Harvard Medical School researchers, the state of fingernail and toenail health is a reliable indicator of his or her general health. Sometimes, these indicators reflect symptoms of underlying disease. Injury or trauma also affect appearance or open the door to other infection-causing pathogens. Seek diagnosis and advice of an experienced board-certified dermatologist such as Dr. Kathleen Smith of Dermatology Specialists of Atlanta when fingernail or toenail disease is present.

Fingernail and toenail diseases may result from bacteria, yeast, or fungi. Discolored tissues help the dermatologist to identify and diagnose most conditions. For example, red and black discoloration indicates trauma. Dark yellow or green colors typically indicate a fungal infection.

Systemic diseases, such as diabetes or anemia, also affect the patient’s fingernails and toenails. In other cases, the patient may suffer from psoriasis, a skin disorder that frequently appears as dry, scaly skin patches (and occasionally presents as fingernail or toenail dystrophy). Most patients with psoriatic fingernails or toenails also have psoriatic arthritis in fingers and toes. In all cases, a board-certified dermatologist can diagnose and help patients best manage health and symptoms.


“Baran and Dawber’s Diseases of the Nails and their Management, Fourth Edition” (2012) says physicians evaluate disease by location, coloration, and shape that presents in the individual fingernail/toenail unit or units. The dermatologist evaluates the fingernail/toenail plate; lateral folds (skin which borders the fingernail/toenail); cuticle (eponychium); matrix/root; lunula/‘half moon’; fingernail/toenail bed; and onychodermal band.

Dermatology Specialists of Atlanta may request a tissue sample in order to evaluate the patient. However, most diseases and disorders are frequently diagnosed based upon location, color, or shape of the fingernail or toenail.


Psoriasis and psoriatic dystrophy may clear without treatment. However, the patient suffering psoriasis usually knows to expect flare-ups or intermittent occurrences. Psoriatic nails have holes, are thickened, or deformed. They are yellow or brown in color. Often, affected fingernails or toenails separate from the skin. Many patients say that the unsightliness of the condition adds stress to daily life. Psoriatic fingernails/toenails are a benign condition that usually does not expose the patient to future complications. There are various treatment options for patients with psoriatic fingernails or toenails, as recommended by Dermatology Specialists of Atlanta.

Fungal infections seldom resolve on their own. People with infections of the fingernails or toenails sometimes report these developed over time. Excessive environmental moisture, sweaty socks and shoes, shared showers or gym space may contribute to the development of fungal disease. Topical treatments are generally ineffective, so Dr. Kathleen J. Smith is likely to recommend either oral anti-fungal medicines or laser fungus removal. Note: Anti-fungal drugs may cause skin reactions, rashes or liver damage.

If oral anti-fungal drugs are prescribed, tell the dermatologist about any existing liver or congestive heart failure conditions. Tell the doctor about any other medications which may conflict with oral anti-fungal drugs.

Paronychia, or a bacteria-caused fingernail or toenail disease, creates plate and/or proximal fold inflammation. The disease may occur once (acute) and then resolve, or become chronic. Paronychia may begin when the fingernail, toenail, or surrounding skin is broken or injured. Researchers say bacteria and some viruses, such as herpes, cause an acute infeciton. Chronic paronychia is a problem for people in constant contact with water or moisture. These patients may suffer episodic flare-ups. Researchers believe that chronic paronychia results from an added fungal attacker, Candida, which is present in all humans from birth.

Dr. Kathleen J. Smith may prescribe antibiotics for bacterial infection or prescribe antivirus medicines for herpes in an acute attack. She may prescribe topical steroids, anti-fungal medicines, and possibly oral anti-fungal or antibiotic medicines for patients suffering with chronic paronychia.


There are many different types of fingernail and toenail diseases. Dermatology Specialists of Atlanta are board-certified dermatologist specialists to help patients in North Decatur, North Atlanta, Tucker, Chamblee, Doraville, Redan, East Point, Forest Park, and greater Atlanta. Call Dr. Kathleen J. Smith to arrange an appointment today at 678-904-4932.

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