Nail changes in diabetes

Abstract

Diabetes is a common condition that is increasing in incidence worldwide. Although the skin manifestations of this condition are well described, there is scant literature on the associated nail changes. In this review, we describe the various clinical features of nail changes associated with diabetes, which can be broadly divided into infections, vascular changes, neuropathic manifestations and miscellaneous changes, although there is overlap between them. There is no pathognomonic nail alteration, but it is important for clinicians to be aware of the potential nail manifestations in diabetes as they can facilitate investigations and thereby early diagnosis of diabetes, resulting in holistic management of the patient. PathogenesisNail and skin changes in DM are significantly associated with hyperglycaemia and the formation of advanced glycation end-products (AGE) due to

Onychogryphosis Is Associated with Dermatologic and Vascular Disease: A Case-Control Study of the All of Us Research Program

“…Chronic hyperglycemia also results in protein glycation, which affects collagen flexibility and keratinocyte proliferation. These factors increase risk for unrecognized nail trauma, onychomycosis, and nail plate hypertrophy, all of which may contribute to onychogryphosis [5, 24].…”

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“…Repetitive trauma, usually from excessive and aggressive manicure and excessive immersion of the hands in soap and water, together with the presence of damage to the cuticle of periungual fold, may result in distortion of the underlying tissues of the nail, causing spaces that can be easily infected. [7][8][9][10][11][12][13][14] Chronic paronychia manifests similarly to the form but lasts longer than six weeks and is caused by multiple factors. 15 Examples include: diabetes, prolonged exposure to water, irritants, manicures, nail trauma and finger sucking.…”