Medical problems
- Connective tissue disease: a particular set of connective tissues disease can cause harm to the nail including the proximal fold and some of these diseases are dermatomyositis [2], lupus erythematosus [3], and systemic sclerosis [4]. These diseases have effects such as visible blood vessels, discoloration, and redness. This medical problem can be treated once the major cause is identified.
- Skin conditions: some skin diseases also affect the nail around the affected skin and this can result in swelling, inflammation, and thickening. Such skin problems are eczema [5], dermatitis, and psoriasis [6].
- Infections: bacterial infections mostly develop in the fold after an injury with symptoms like redness, pain, pus, tenderness, and swelling. Bacterial infections can be treated with topical antibiotics. Fungal infections affect the whole nail, the proximal subungual onychomycosis infection starts from the fold and spreads throughout the nail. This particular infection mostly affects people with complicated immune systems. Fungal infections can be treated by topical antifungal medications.
- Reactions to allergens and irritants: if the fold is continuously exposed to its irritants and allergens, it can become inflamed. Cooks, house cleaners, swimmers, and dry cleaners are prone to these reactions. This can be prevented by wearing gloves and also topical steroid creams can be of use for such reactions.
- Physical trauma: trauma such as cuts or skin breaks can lead to inflammations, physical trauma separates the nail from the nail bed. Retronychia is a form of physical trauma in which a new nail grows beneath the old one and pushes it upward. Examples of physical trauma are biting of the nail, application of fake fingernails, removal of the cuticle, wearing poorly fitted shoes, and application of physical pressure. If the fold is cut or broken, it should be treated like any other wound but for retronychia, medical personnel should be the one to remove the old nail. The most common type of physical trauma is paronychia.