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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Ridges on the toe nails, toe nails coming off, no discoloration, history of benign cysts and tumors, cancer in the family. Serious problem?

Answered by
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Dr. P V S Prasad

Dermatologist

Practicing since :1980

Answered : 254 Questions

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Posted on Mon, 4 Jun 2012 in Skin Hair and Nails
Question: I have XXXXXXX ridges across both big toe nails and it looks like i may also have ridges on the smaller ones too. The two big toe nails are coming off at the base of the nail. There is no sign of infection, no nail discolouration and i have been wearing trainers and flip flops. I have had no injury. I do have a past histroy of surgeries for benign cysts and also tumours. Most recently i had brain surgery. I have had 9 surgeries in the past. A history of cancer in the family. Both parents died of cancer young father 65 and mother 55 years of pancreatis cancer. Should i be worried about a more serious underlying disease?
doctor
Answered by Dr. P V S Prasad 24 hours later
Hi,

Thank you for the query.

It is not right that simple nail problems as yours is related to any serious underlying condition. We generally relate the nail problems and investigate further after examining their color, shape, texture, easy breakability and ridges.

Simple Ridges can be a normal variation, a transverse ridge can be significant if it is associated with depression (Beau's lines). Otherwise transverse ridges that appear only on great toe nails may not hold importance. They appear during any kind of stress like frequent surgeries, fever, infection, inflammation, menstrual problems, during a period of protein deficiency.

If you were my patient I try to investigate further to rule out the simple causes like local nail bed infection (fungal), Anemia, protein deficiency, menstrual problems since you have a medical history and positive family history. I would investigate with these first
1) KOH examination of the scrapings from the nail bed
2) Hemogram
3) Serum albumin and total protein
4) Liver Function

You can ask a local physician to do general examination including the sclera, tongue, nail beds, palm and skin texture, lymph nodes. He may recommend the above mentioned tests accordingly.

Same time you have to make sure that the feet are dry all the time, rub them in between the toes immediately with a dry cloth each time after shower, removal of socks. A simple home measure like keeping feet in the hot water tub with Epsom salt in it and later dry them off may help in treating local infection.

Hope I answered your query. Let me know if you have further doubts.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. P V S Prasad 42 minutes later


Hi, Thank you for your answer. I was looking on line regarding Beau's lines. Comparing pictures of this with my toe nails i am quite certain that i have Beau's lines which are quite noticeable and indented across both big toes and which are appearing on the smaller toes as well. There is no sign of an infection. The nail has almost come off on one of my toes and the other is starting to lift too. The base of the nail bed is developing another indentation almost at the cuticle very indented. There is no new nail growth underneath. The underneath is dry and no sign of infection or bleeding.

If it is a Beaus line what illnesses can cause these to appear?

doctor
Answered by Dr. P V S Prasad 52 minutes later
Hi,

Thanks again for following up.

Beau's lines represent nutritional problems pr injury to the nail. So my earlier causes still hold good except for the infection.

These are the factors of Stress like Anemia, protein deficiency, menstrual problems that needs to be ruled out. Multiple surgeries would have lead to imbalanced nutrition and may also be a cause (if relevant).

You will need to work closely with your Family doctor on this matter. A thorough physical examination and tests as suggested in my previous reply are entailed.

Hope this helps

Wish you good health and speedy recovery.

Regards
Above answer was peer-reviewed by : Dr. Prasad
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