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Biting

There are a lot of reasons why someone would bite their nails. It can be that they need to comfort
themselves because they are stressed, to pass time or they are just perfectionists. Someone who needs
to pacify his or her anxiety and stress will bite nails and cuticles without worrying about perfection.
Someone who needs to pass time will bite his nails but not cuticles and there`s the key difference. And
finally a perfectionist will bite them in order to correct imperfections. Notice their behavior when biting
their nails. If they look at them after each bite than it`s safe to say that they are perfectionists.

Personality
The nails can also betray someone`s personality especially in woman. It`s important to notice a
decoration of the nails because there`s a lot of information there. At first glance you`ll be able to tell if a
woman`s fingernails were done by a professional or at home. It is usually more symmetrical and glossy if
it`s professionaly applied and it also lasts longer. Nails painted at home will have visible mistakes usually
on dominant hand. Nail polish will have visible cracks after two weeks and glossy finish fades after a
week. You`ll be able to tell how long it has been since the it`s applied by looking at the space between
the polish and base of the nail. Now there`s some correlation between the color of the nails and
personality.

- Polka dots and stripes- this suggests outgoing personality and a person is energetic and
lively
- Solid, basic colors- indicates a conservative and agreeable individual
- Bright colors- it`s seen on woman who are outgoing and energetic. High extroversion.
- Too much decorated- a lot of work put into decoration points to need for attention but also
to a certain degree uncertainty about appearance. Sometimes you can see small diamonds
attached which shows that there`s a lot of work put in the process to look good.
- Red nail polish- it shows that a person who wears it is very confident. It`s usually seen in
businesswoman
- Artistic designs- creative
Deducing health
Human nails are complex structures involving 3 different layers:

- The nail plate


- The nail bed
- Cuticule

Nail examination can provide us with subject`s emotional state, occupation and hobbies, health,
personality. Systematic illness should show the nail changes in each of the nails in one hand. Nail growth
is continuous. The middle finger nails grows fastest followed by index and ring finger. Also nails on
dominant hand grow faster because of the minor trauma accelerates nail growth. Understanding the
nail growth is important because the time interval from critical event can be estimated from the location
of the nail lesion. For example, a white line appearing halfway up the nail suggests illness 3 months
earlier. Distance from the base and line of polish gives approximate date of application ( nails grow
0.1mm/day).

Examination of the nail:


Lunula

-First thing to notice if lunula at the base of the nail. A red lunula is often seen in cardiovascular illness
such as congestive heart failure. A pointed lunula suggests repeated trauma such as excessive manicures
or psychiatric illness. The absence of lunula may indicate anemia or undernutrition.

Various nail abnormalities


Paronychias

It suggests stress and poor attention to hygiene. This can reflect depression, dementia or psychiatric
illness.
Beau`s lines

The lines look as if a little furrow had been plowed across the nail. Location of the line can give
approximate date of the illness. Also the depth of the lines provide us with the severity of the illness.

If there is a line in a middle it suggests some kind of illness approximately three months ago. Two Beau`s
lines suggest illnesses about 2 months apart.

Koilonychia

It`s also called spoon nails. They suggest iron deficiency, diabetes mellitus or deficiency in iron sulfur-
containing amino acids. Soft thin spoon nails are seen in iron deficiency and deficiency in amino acids.
Uncontrolled diabetes can produce koilonychia with thick nails.
Nail deformities
They can result from nutritional deficiency, infection, trauma and variety of diseases.

Central ridge

A central thin ridge can be seen in nutritional deficiency (iron, folic acid or protein deficiency).

Heller`s deformity

A central canal with a fir tree appearance is called Heller`s deformity and implies peripheral arterial
disease, malnutrition or repetitive trauma.

Nail beading

It is associated with endocrine conditions like diabetes mellitus, thyroid disorders, Addison`s disease and
vitamin B deficiency.
Onycholysis

Refers to separation of the nail plate from the nail plate. Areas of separation appear white or yellow. It`s
most commonly associated with trauma, thyrotoxocisis, psoriasis (there are also pits in the nails) , drugs
(tetracyclines) and chemical exposures.

Brittle nails

Metabolic bone disease, thyroid disorder, systematic amyloidosis, severe malnutrition.

Nail pitting

Psoriasis (random pits), alopecia areata ( geometric rippled grid), eczema, lichen planus.
Clubbing

Pulmonary and cardiovascular disease account for 80% of clubbing.

Nail discolorations
Minor trauma to the nail can injure the capillaries below the nail base. The result is white spot that
appears on the nail. Vascular disease causes nail opacity. Raynaud`s can cause brittle nails with
longitudinal ridges and pterygia. Scleroderma produces dusky curved nails.

Mee`s lines

Any acute illness can produce milky white lines called Mee`s lines in the setting of arsenic poisoning.

Muehrcke`s lines

Muehrcke`s lines are caused by low serum albumin.


Terry`s nails

Terry`s nails suggest chronic renal or liver disease. If there is a rust color line at the free edge, consider
renal disease as the cause, no brown discoloration suggests liver disease. When the lunula and lower
half of the nail is red and upper half is pale is present than it suggests congestive heart failure, severe
lung disease or lymphoma. A completely pink nail indicate heart failure and sometimes vitamin C and B
deficiency. Lilac-colored nail may signify chronic congestive heart failure.

Splinter hemorrhages

Small, fat , red, longitudinal lines in the nails are called splinter hemorrhages, an important clue of
infectious endocarditis.

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