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. 2014 Apr 7;2(3):e115.
doi: 10.1097/GOX.0000000000000057. eCollection 2014 Mar.

Clinical Evidence for the Relationship between Nail Configuration and Mechanical Forces

Hitomi Sano  1 , Rei Ogawa  1
Affiliations

Clinical Evidence for the Relationship between Nail Configuration and Mechanical Forces

Hitomi Sano et al. Plast Reconstr Surg Glob Open. .

Abstract

Mechanobiology is an emerging field of science that focuses on the way physical forces and changes in cell or tissue mechanics contribute to development, physiology, and disease. As nails are always exposed to physical stimulation, mechanical forces may have a particularly pronounced effect on nail configuration and could be involved in the development of nail deformities. However, the role of mechanobiology in nail configuration and deformities has rarely been assessed. This review describes what is currently understood regarding the effect of mechanical force on nail configuration and deformities. On the basis of these observations, we hypothesize that nails have an automatic curvature function that allows them to adapt to the daily upward mechanical forces. Under normal conditions, the upward daily mechanical force and the automatic curvature force are well balanced. However, an imbalance between these 2 forces may cause nail deformation. For example, pincer nails may be caused by the absence of upward mechanical forces or a genetic propensity increase in the automatic curvature force, whereas koilonychias may occur when the upward mechanical force exceeds the automatic curvature force, thereby causing the nail to curve outward. This hypothesis is a new concept that could aid the development of innovative methods to prevent and treat nail deformities.

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Figures

Fig. 1.
Fig. 1.
Hypothesis to explain the mechanism underlying the development of nail deformities. Under normal conditions, the upward mechanical force on the nail and its automatic curvature force are well balanced. However, if the upward mechanical force exceeds the automatic curvature force, the nails curve outward. Conversely, if the automatic curvature force exceeds the upward mechanical force, the nails curve inward.
Fig. 2.
Fig. 2.
Typical appearance of koilonychias. The nail plate has a concave form.
Fig. 3.
Fig. 3.
Typical appearance of pincer nail. Transverse overcurvature of the nail plate is observed.
See this image and copyright information in PMC

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