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Anatomie, Biologie, Physiologie und Grundzüge der Pathologie des Nagelorgans

Anatomy, biology, physiology and basic pathology of the nail organ

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Zusammenfassung

Der Nagel ist das größte Hautanhangsgebilde. Er wächst lebenslang ohne Abhängigkeit von Hormonen. Der Mittelfingernagel der dominanten Hand eines jungen Erwachsenen wächst im Durchschnitt 0,1 mm/Tag, der Großzehennagel 0,03–0,05 mm/Tag. Die Form und Größe der Nägel sind von Finger zu Finger und von Zehe zu Zehe in sehr charakteristischer Weise unterschiedlich, wofür in erster Linie der Knochen der Endphalangen verantwortlich ist. Das Nagelorgan besteht aus verschiedenen epithelialen und bindegewebigen Anteilen: Das Matrixepithel bildet die Nagelplatte, das Nagelbettepithel sorgt für eine feste Haftung des Nagels, das Hyponychium ist eine hoch spezialisierte Struktur, die es erlaubt, dass sich der Nagel problemlos vom Nagelbett ablösen kann und doch kein Spalt zwischen Nagel und Nagelbett entsteht, und schließlich ist der dorsale Nagelwall für den Schutz der Nagelwurzel und die Bildung der Kutikula an seinem freien Rand für die Versiegelung der Nageltasche verantwortlich. Nagelbett und Matrix haben ein spezialisiertes Bindegewebe mit morphogenetischer Potenz. Der proximale und die lateralen Nagelwälle bilden einen nach distal offenen Rahmen für den Nagel. Der Nagel bietet Schutz für die Endphalanx und die Fingerspitze, ist ein äußerst nützliches Werkzeug zur Verteidigung und Geschicklichkeit und erhöht die Sensibilität der Fingerspitze. Nagelapparat, Fingerspitze, Sehnen und Ligamente des Endgelenkes bilden eine funktionelle Einheit und können in vieler Hinsicht nicht isoliert gesehen werden. Das Nagelorgan hat nur eine gewisse Anzahl an Erkrankungsmustern, die sich in mancher Hinsicht von denen der behaarten und der palmoplantaren Haut unterscheiden.

Abstract

The nail is the largest skin appendage. It grows continuously through life in a non-cyclical manner; its growth is not hormone-dependent. The nail of the middle finger of the dominant hand grows fastest with approximately 0.1 mm/day, whereas the big toe nail grows only 0.03–0.05 mm/d. The nails’ size and shape vary characteristically from finger to finger and from toe to toe, for which the size and shape of the bone of the terminal phalanx is responsible. The nail apparatus consists of both epithelial and connective tissue components. The matrix epithelium is responsible for the production of the nail plate whereas the nail bed epithelium mediates firm attachment. The hyponychium is a specialized structure sealing the subungual space and allowing the nail plate to physiologically detach from the nail bed. The proximal nail fold covers most of the matrix. Its free end forms the cuticle which seals the nail pocket or cul-de-sac. The dermis of the matrix and nail bed is specialized with a morphogenetic potency. The proximal and lateral nail folds form a frame on three sides giving the nail stability and allowing it to grow out. The nail protects the distal phalanx, is an extremely versatile tool for defense and dexterity and increases the sensitivity of the tip of the finger. Nail apparatus, finger tip, tendons and ligaments of the distal interphalangeal joint form a functional unit and cannot be seen independently. The nail organ has only a certain number of reaction patterns that differ in many respects from hairy and palmoplantar skin.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. E. Haneke gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Dermaticum Freiburg, Schlippehof 5, 79110, Freiburg, Deutschland

    E. Haneke

  2. Dermatol. Klinik Inselspital, Universität Bern, Bern, Schweiz

    E. Haneke

  3. Centro Dermatol Epidermis, Porto, Portugal

    E. Haneke

  4. Kliniek voor Huidziekten, Academisch Ziekenhuis, Univ. Gent, Gent, Belgien

    E. Haneke

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Haneke, E. Anatomie, Biologie, Physiologie und Grundzüge der Pathologie des Nagelorgans. Hautarzt 65, 282–290 (2014). https://doi.org/10.1007/s00105-013-2702-2

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