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Underlying Medical Conditions That Can Cause Black Lines on Nails

Black lines on nails can be a cause for concern, especially when they appear unexpectedly. While they can be caused by minor injuries or trauma, they can also be a sign of underlying medical conditions. In this article, we will discuss some of the medical conditions that can cause black lines on nails.

  1. Introduction

    Nails are composed of layers of protein called keratin. They are attached to the nail bed, which is located underneath the nail. Black lines on nails can be caused by several factors, including trauma, medication-induced changes, and systemic diseases. However, they can also be a symptom of serious conditions, such as melanoma and endocarditis.

  2. Melanoma

    Melanoma is a type of skin cancer that can develop under the nails. It is the most serious condition that can cause black lines on nails. Melanoma can manifest as a black or brown line on the nail, which can gradually widen and darken. It can also cause the nail to become brittle, thickened, and deformed. Risk factors for developing melanoma on a nail include a personal or family history of melanoma, fair skin, and excessive sun exposure. (1)

    Diagnosis of melanoma on a nail involves a biopsy of the nail bed or matrix. Treatment may involve surgical removal of the nail or the affected tissue, radiation therapy, or chemotherapy.

  3. Subungual Hematoma

    Subungual hematoma is a medical term used to describe bleeding under the nail. It can be caused by trauma, such as hitting a finger or toe, or by repetitive pressure. Subungual hematoma can cause a black or purple line on the nail, which can be painful and tender. (2)

    Diagnosis of subungual hematoma involves physical examination and may involve imaging tests, such as X-rays or ultrasound. Treatment may involve draining the blood from under the nail or removing the nail if it is severely damaged.

  4. Medication-induced Nails Changes

    Certain medications can cause changes to the nails, including black lines. Chemotherapy drugs, antibiotics, and antimalarial medications are some of the drugs that can cause black lines on nails. These medications can affect the growth and development of the nail, causing it to become discolored and deformed. (3)

    Diagnosis of medication-induced nail changes involves reviewing the patient’s medical history and performing a physical examination. Treatment may involve switching to a different medication or discontinuing the drug.

  5. Systemic Diseases

    Several systemic diseases can cause nail changes, including black lines. Endocarditis is a condition where the lining of the heart becomes infected. It can cause black lines on the nails, along with other symptoms such as fever, fatigue, and shortness of breath. Other systemic diseases that can cause nail changes include lupus, rheumatoid arthritis, and psoriasis. (4)

    Diagnosis of systemic diseases involves reviewing the patient’s medical history, performing a physical examination, and conducting laboratory tests. Treatment may involve medication, lifestyle changes, or surgery.

  6. Other Possible Causes of Black Lines on Nails

    Other less common causes of black lines on nails include fungal infections and traumatic injuries. Fungal infections can cause the nail to become discolored and brittle, while traumatic injuries can cause blood to collect under the nail. (5)

    Diagnosis of fungal infections involves physical examination and laboratory tests. Treatment may involve antifungal medication or surgical removal of the nail. Treatment of traumatic injuries may involve draining the blood from under the nail or removing the nail if it is severely damaged.

  7. Conclusion

    In conclusion, black lines on nails can be a symptom of underlying medical conditions. These conditions include melanoma, subungual hematoma, medication-induced nail changes, and systemic diseases such as endocarditis. Early detection and treatment of these conditions can improve outcomes and prevent further complications. If you notice black lines on your nails, it is important to seek medical attention to determine the underlying cause. While some causes of black lines on nails may be benign, others can be life-threatening.

    It is also important to note that not all black lines on nails are indicative of a medical condition. In some cases, they may be caused by minor injuries or trauma, or they may be a result of normal aging. However, if you are unsure about the cause of black lines on your nails, it is best to consult with a healthcare professional.

    In summary, the appearance of black lines on nails can be concerning, but it is important to remember that they can be caused by a variety of factors. By understanding the potential underlying medical conditions that can cause black lines on nails, you can be better equipped to recognize when to seek medical attention and receive appropriate treatment.

References:

  1. Melanoma – American Academy of Dermatology Association. (n.d.). Melanoma: Overview. Retrieved from https://www.aad.org/public/diseases/skin-cancer/melanoma
  2. Subungual Hematoma – Mayo Clinic. (2020, September 4). Subungual hematoma. Retrieved from https://www.mayoclinic.org/diseases-conditions/subungual-hematoma/symptoms-causes/syc-20374567
  3. Medication-induced Nails Changes – American Academy of Dermatology Association. (n.d.). Nails and Health. Retrieved from https://www.aad.org/public/everyday-care/nail-care-secrets/nails-and-health
  4. Systemic Diseases – Mayo Clinic. (2020, July 23). Nail pitting or pitted nails. Retrieved from https://www.mayoclinic.org/symptoms/nail-pitting/basics/causes/sym-20050638
  5. Other Possible Causes of Black Lines on Nails – American Osteopathic College of Dermatology. (n.d.). Nail Fungus. Retrieved from https://www.aocd.org/page/NailFungus and Mayo Clinic.
  6. (2019, September 17). Subungual melanoma: Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/subungual-melanoma/symptoms-causes/syc-20355916
Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:April 7, 2023

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