Nail Diseases in Children

Abnormalities in the nails of children can simply be cosmetic issues, but sometimes are symptoms of a more serious disease. Psoriasis, lichen planus, alopecia areata, epidermolysis bullosa, herpetic whitlow and onychomycosis are some of the most common diseases that affect nails in children.

Onychomycosis

• Onychomycosis is the result of a fungal infection that causes nails to be thick, discolored or even disfigured. Treatment is necessary to avoid the nails becoming so thick that they cause pain. Toenails are affected more so than fingernails and onychomycosis is seen much more frequently in adults than in children. For mild to moderate cases, topical treatment is often used. More severe cases in children require taking anti-fungal capsules.

Alopecia Areata

• Alopecia Areata (AA) is a hair loss disease, but often causes changes in nails. Nail pitting, the nail becoming concave, nail shedding and red skin around the nail are possible symptoms of AA, as well as hair loss. There is currently no known cure; however, topical treatments exist.

Lichen Planus

• Lichen planus (LP) is an inflammatory disease of the skin and mouth. LP is mostly characterized by an intense itch and can cause nail changes, specifically at the root of the nail. Typical symptoms include ridging, splitting, thinning or nail loss; however, most cases of LP are seen in middle-age adults and are rare in children.

Epidermolysis Bullosa

• Epidermolysis bullosa (EB) is a genetic disorder where the two layers of skin, the epidermis and dermis, lack connectors to hold them together. Friction is created by the rubbing of the two layers. As a result, you get blisters and painful sores. Children with EB have been referred to as "Butterfly Children," "Cotton Wool Babies" or "Crystal Skin Children" due to the skin being extremely fragile. There is no known cure for EB.

Psoriasis

• Psoriasis of the nails is different than psoriasis of the skin, but most people who have nail psoriasis also have skin psoriasis. Children often will show this condition around school age with the nails becoming pitted or rough. Psoriasis is chronic with no known cure and will last throughout a child's life; however, it is known to go into remission from time to time.

Herpetic Whitlow

• Herpetic whitlow (often called "hand herpes" or "finger herpes") is caused by the herpes simplex virus (HSV). It is common in children as a result of thumb-sucking with an infection on the mouth or lips. Like all strains of the herpes virus, it is very contagious, even if symptoms are not present. Herpetic whitlow actually occurs on the skin anywhere on the finger, but often on the nail bed. Symptoms will usually clear themselves up in a matter of weeks.