Nail Bed Lesions (6)

  • Dirk Hochlenert
  • Gerald Engels
  • Stephan Morbach
  • Stefanie Schliwa
  • Frances L. Game


Pressure is the main factor inducing damage to the nail and its bed. Underestimated, insidious and repeated trauma facilitates deformities of the nail, and infection by bacteria or fungi (Onychomycosis). Skin compensates for pressure by a thickening of its superficial layers. The nail bed can do so only to a limited extent, as each thickening of the nail (Onychogryphosis) increases the pressure exerted within a shoe or facilitates levering. As a consequence, the nail bed is less able to react and protect itself than the surrounding tissue and therefore might provide an early sign of excessive pressure and indicate the need for introduction of protective measures.


  1. 1.
    Waldeck M. Unguis incarnatus: Die Emmert-Plastik und ihre Alternativen. ChirurgenMagazin. 2012;10(4):42–6.Google Scholar
  2. 2.
    Scholz N. Konservative Behandlung eingewachsener Zehennägel mit Nagel-Korrekturspangen. Dtsch Arztebl. 2000;97(22):A1532.Google Scholar
  3. 3.
    Papini M, Cicoletti M, Fabrizi V, Landucci P. Skin and nail mycoses in patients with diabetic foot. G Ital Dermatol Venereol. 2013;148(6):603–8.PubMedGoogle Scholar
  4. 4.
    Borgers M, Degreef H, Cauwenbergh G. Fungal infections of the skin: infection process and antimycotic therapy. Curr Drug Targets. 2005;6(8):849–62.CrossRefPubMedGoogle Scholar
  5. 5.
    Tietz HJ. Nagelpilz ist heilbar. Der Hausarzt. 2012;(16).Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Dirk Hochlenert
    • 1
  • Gerald Engels
    • 2
  • Stephan Morbach
    • 3
  • Stefanie Schliwa
    • 4
  • Frances L. Game
    • 5
  1. 1.Amb. Zentrum für DiabetologieEndoskopie & Wundheilung GemeinschaftspraxisKölnGermany
  2. 2.Department of Wound SurgerySt. Vinzenz Hospital and MVZ St. MarienKölnGermany
  3. 3.Department of Diabetes and AngiologyMarienkrankenhaus GmbHSoestGermany
  4. 4.Institute of Anatomy, Anatomy and Cell BiologyUniversity of BonnBonnGermany
  5. 5.Department of Diabetes and EndocrinologyDerby Hospitals NHS Foundation TrustDerbyUK

Personalised recommendations