Nail brittleness (NB) is characterized by nails that are prone to splitting, flaking, and crumbling, and potentially becoming soft and inelastic [1, 2]. The nail plate (NP), which is produced in the nail matrix (NM), comprised roughly 25 layers of densely packed, completely differentiated cells called onychocytes, forming a 0.5–1 mm thick, fully keratinized structure with a smooth surface [2, 3]. The NM is localized under the proximal nail fold. NB is thought to occur due to factors that alter NP production and/or factors that damage the already formed NP [1, 2]. It may occur secondary to dermatologic and systemic diseases, nutritional deficiencies, and drug intake [2]. When none of these causes are identified, the condition is defined as idiopathic or referred to as brittle nail syndrome, which is the most common type of NB [2]. In the idiopathic form, electron microscopy shows an intrinsic or acquired defect in intracellular cement substance or the keratinous lamellae holding together onychocytes [3, 4]. Cell adhesion in the NP is facilitated by membrane-coating granules with linkage by lipids, and therefore, low lipid content in the NP contributes to the pathogenesis of NB [1, 2].

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Brittle Nails

  • Jose W. Ricardo,
  • Shari R. Lipner

摘要

Nail brittleness (NB) is characterized by nails that are prone to splitting, flaking, and crumbling, and potentially becoming soft and inelastic [1, 2]. The nail plate (NP), which is produced in the nail matrix (NM), comprised roughly 25 layers of densely packed, completely differentiated cells called onychocytes, forming a 0.5–1 mm thick, fully keratinized structure with a smooth surface [2, 3]. The NM is localized under the proximal nail fold. NB is thought to occur due to factors that alter NP production and/or factors that damage the already formed NP [1, 2]. It may occur secondary to dermatologic and systemic diseases, nutritional deficiencies, and drug intake [2]. When none of these causes are identified, the condition is defined as idiopathic or referred to as brittle nail syndrome, which is the most common type of NB [2]. In the idiopathic form, electron microscopy shows an intrinsic or acquired defect in intracellular cement substance or the keratinous lamellae holding together onychocytes [3, 4]. Cell adhesion in the NP is facilitated by membrane-coating granules with linkage by lipids, and therefore, low lipid content in the NP contributes to the pathogenesis of NB [1, 2].