Fungal Nail Infection vs Other Nail Disorders: Spot the Difference

Fungal nail infection (onychomycosis) is a common condition that affects millions of people worldwide. It is caused by various types of fungi, including dermatophytes, yeasts, and molds.

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Fungal nail infections can cause thickened, discolored, and brittle nails that may be painful or uncomfortable. While fungal nail infections are the most common cause of nail discoloration and deformity, other conditions can also affect the nails.

Differentiating between fungal nail infections and other nail disorders can be challenging due to their similar clinical presentations. Nail disorders such as psoriasis, lichen planus, eczema, trauma or injury to the nails, and bacterial infections can mimic fungal nail infections in appearance.

Therefore, accurate diagnosis is crucial for proper treatment and management of these conditions. This article aims to provide an overview of fungal nail infections and other common nail disorders, highlighting their clinical presentations and diagnostic methods to aid in distinguishing between them.

Overview Of Fungal Nail Infection

Fungal nail infection, also known as onychomycosis, is a common nail disorder caused by a fungal organism.

It affects the nails of both hands and feet, with toenails being more commonly affected than fingernails.

The fungus can invade the nail plate and spread to the surrounding tissues causing thickening, yellowing or discoloration of the nails.

In severe cases, it may cause pain or discomfort while walking or wearing shoes.

Fungal nail infections are prevalent among older adults and people with weakened immune systems due to diabetes, HIV/AIDS or other medical conditions.

The diagnosis of fungal nail infection requires laboratory testing of nail samples for culture and microscopy.

Treatment options include topical antifungal agents, oral antifungal medications or surgical removal of the infected nail.

Successful treatment requires long-term therapy and proper management of underlying medical conditions that increase the risk of developing fungal nail infections.

Psoriasis Of The Nails

According to the National Psoriasis Foundation, psoriasis affects about 2-3% of the global population.

Approximately half of people with psoriasis will have nail involvement, and up to 80% of those with psoriatic arthritis also experience nail changes.

Psoriasis of the nails presents as pitting, ridges, discoloration, and thickening.

Additionally, onycholysis (separation of the nail plate from the nail bed), splinter hemorrhages (tiny blood clots under the nails), and subungual hyperkeratosis (build-up of skin under the nails) may occur.

These symptoms can make it difficult to distinguish between psoriasis and fungal infections.

However, physicians can use clinical examination alongside laboratory tests like fungal cultures and biopsies to differentiate between these two conditions.

Proper diagnosis is essential for effective treatment planning to manage each condition’s unique underlying causes and symptoms.

Lichen Planus Of The Nails

Lichen planus of the nails is a medical condition that affects the nail bed, causing discoloration and thickening of the nail plate. Symptoms of lichen planus include whitish-yellow spots on the nail surface, nail brittleness and nail fragility. The cause of lichen planus of the nails is not fully understood but is thought to be associated with an autoimmune reaction. Treatment of lichen planus of the nails may include topical medications, systemic medications, and light therapies.

Symptoms Of Lichen Planus

Lichen Planus of the Nails is a rare condition that can cause emotional distress to those affected.

Symptoms of Lichen Planus include nail thinning, nail ridges, and splitting of the nail plate.

The nails may also become discolored and have irregular lines or pits on the surface.

In severe cases, the nails may detach from the nail bed.

These symptoms can cause discomfort and pain, making it difficult for individuals to perform daily activities.

Proper diagnosis and treatment are crucial in managing Lichen Planus of the Nails.

Causes Of Lichen Planus

Understanding the causes of Lichen Planus of the Nails is important for proper diagnosis and treatment.

The exact cause of this condition is unknown, but it is believed to be an autoimmune disorder in which the immune system attacks healthy cells in the body, including those in the nails.

It may also be triggered by certain medications, infections, or allergies.

Additionally, genetics may play a role in the development of Lichen Planus.

By identifying and addressing the underlying cause, healthcare professionals can provide appropriate treatment options for individuals with this condition.

Treatment Of Lichen Planus

After identifying the underlying cause of Lichen Planus of the Nails, healthcare professionals can offer various treatment options to alleviate symptoms and prevent further complications.

The treatment plan may involve topical or oral medications, such as corticosteroids, retinoids, and immunosuppressants.

In severe cases, surgery may be necessary to remove the affected nail.

Additionally, lifestyle changes like avoiding triggers and maintaining good nail hygiene can also help manage the condition.

It is essential to work closely with a healthcare provider to determine the most effective treatment approach for each individual case of Lichen Planus of the Nails.

Eczema Of The Nails

Eczema of the nails, also known as nail psoriasis, is a chronic inflammatory condition that affects approximately 1-3% of the population.

It is characterized by thickened, discolored, and pitted nails that can become brittle and prone to breakage.

The condition can affect one or multiple nails and is often associated with skin psoriasis.

In terms of symptoms, eczema of the nails can cause discomfort, pain, and even deformity in severe cases.

To diagnose this condition, a dermatologist may perform a physical examination of the nails along with skin biopsies and laboratory tests.

Treatment options include topical creams, oral medication, phototherapy, or systemic immunosuppressive agents.

However, due to the chronic nature of nail psoriasis, it may require long-term management to control symptoms and prevent further damage to the nails.

Overall, it’s essential for individuals experiencing any nail abnormalities to seek medical advice promptly to receive an accurate diagnosis and appropriate treatment plan.

Trauma Or Injury To The Nails

In contrast to eczema of the nails, trauma or injury to the nails can cause various nail disorders.

The most common types of nail trauma include subungual hematoma, which is bleeding under the nail plate caused by a crushing injury, and onycholysis, which is separation of the nail plate from the underlying nail bed due to mechanical stress or chemical exposure.

Other types of traumatic nail disorders include split nails, bruised nails, and ingrown toenails.

These conditions can be painful and may require medical treatment depending on their severity.

It is important to seek medical attention if you suspect a traumatic injury to your nails in order to prevent further complications.


In conclusion, fungal nail infection is a common condition that affects many individuals. It is important to distinguish it from other nail disorders such as psoriasis, lichen planus, eczema, and trauma or injury to the nails. These conditions may present similar symptoms but require different treatment options.

Psoriasis of the nails can cause pitting, ridges and discoloration of the nails.

Lichen planus of the nails can cause thinning and splitting of the nails.

Eczema of the nails can result in thickened and discolored nails.

Trauma or injury to the nails may also result in changes to their appearance.

Understanding and identifying these differences can help healthcare professionals provide accurate diagnoses and treatments for patients with nail disorders. Early diagnosis and treatment are essential in preventing further complications and improving outcomes.

In summary, proper identification of nail disorders is crucial to ensure appropriate management. Patients should be encouraged to seek medical advice if they notice any changes in their nails’ appearance or texture.

Healthcare providers must remain vigilant when assessing patients with nail symptoms to ensure prompt diagnosis and treatment of any underlying conditions.