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    Dr. Tareen, my beautiful lunula gone on fingernails
    justmejust posted:
    Dr. Tareen, My beautiful white lunulas are gone from my fingernails. And they are growing slow whereas always needed trimming a few times a week. There are parallel lines on them have become very unevenly raised too.

    What could this be? I am of stable health, with routine blood tests showing my elevated cholesterol of 250 and elevated glucose of 106, of which both have been in elevated range for a couple years despite increasing walking and improving nutrition. I continue to walk more and improve focus on balanced meals. Have lost 18 pounds in last year, with 40 more to go.

    My primary doctor did not have an answer about my fingernails even when I asked again after all my blood tests came back in normal range except for the above established areas. cbc, vit d, anemia, kidney and liver, and more all fine.
    Mohiba K Tareen, MD responded:
    Dear Justmejust,

    Let me commend you on your weight loss and exercise. That is wonderful. I am so proud of you and keep up the great work!

    The most common causes of lost lunula include malnutrition, stress and iron deficiency anemia. I am happy that all of your blood tests are relatively normal. Please insure you are eating a balanced diet and taking a multivitamin.

    A few other possibilities:
    -Your fragile nails and loss of lunula may indicate a biotin deficiency. Biotin (vit B7) is essential to good nail health. Although you should always check with your physician- I typically recommend 3000 mcg a day of biotin to help strengthen the nails of my patients. The excess biotin in excreted in your urine so there is little risk of overdose.

    -The uneven lines in your nails may indicate an actual disease of the nails - the most common being psoriasis or lichen planus. You should definitely see your derm for evaluation. Once the nails are scarred from these conditions, it is permanent so I really want you to see your dermatologist soon please!

    Please keep me updated, I hope this helps.
    justmejust replied to Mohiba K Tareen, MD's response:
    Dr. Tareen, Thank you for your thoughtful response.

    I made the appointment with my dermatologist to look at the uneven raised parallel lines in my nails where they were always smooth before.

    The nail bed colors are a little blue and yellowish and dry looking whereas they had always been pink and shiny and smooth, and the tips are yellowish and breaking/splitting on what had always been healthy white tips.

    Where the blue bed of nail meets the yellow tip of nail that meeting area is starting to appear as a jagged line, reflecting the uneven raised parallel ridges which in a few places even resemble narrow thin boils. I always had a beautiful seamless transition before.

    I will increase my biotin with supplements, and perhaps foods, and discuss these things with my dermatologist when I see him.

    It's just so frustrating that my nails are becoming so different from my normal nail look.

    I had a case of what was termed sebacious dermatitis/ dandruff on my scalp by the dermatologist over 2 years ago. At times since then and especially this summer my scalp was so terribly itchy that I would scratch it quite often. It has recently been clearing up with a shampoo change.

    Is it likely that what is in my fingernails now is also on my scalp too, and if both could be lichen planus or dermatitis?

    I have been going through some average stress in life with three teens and some marital and employment stress the last year.

    I do try to relax, meditate, focus on nutrition and exercise and hope to reach goal weight, but have much room for improvement to reach healthier weight, improved blood LDL, Triglyceride, and glucose.
    Mohiba K Tareen, MD replied to justmejust's response:
    I commend you again on your health endeavors my dear!

    Actually the scalp rash may be consistent with psoriasis, as may be the nails. Please keep me updated after you see the derm
    johnwayne responded:
    I have several scale like spots on my skin. What is this? Do I need to see a doctor?
    johnwayne replied to Mohiba K Tareen, MD's response:
    Thank you.

    Featuring Experts

    Mohiba K Tareen, MD is a board certified dermatologist who has an innovative practice in Roseville, Minnesota. Tareen Dermatology ( www.TareenDermato...More

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