The impact of nail disorders on quality of life

Nail disorders have considerable psychological impact and may limit activity by impairing functionality of both fingers and toes.

To evaluate the impact of nails disorders on quality of life (QoL).

1063 patients with nail disorders completed an anonymous nail-specific QoL questionnaire consisting of 24 and 16 questions, respectively, for fingernails and toenails with five possible responses to each question. A score of 1-5 was given to each response and the final score was adjusted on a percentile scale. The subjects were classified in groups according to nail disorders. Statistical analysis was carried out using T-test to compare the means between two groups and ANOVA analysis of variance to compare the impact of quality of life on the different types of nail disorders.

Comparison between groups showed a statistically significant higher impact for trauma, onychomycosis, other infections, structure abnormalities, psoriasis, other inflammatory diseases and paronychia and a lower impact for chromonychias and tumours. QoL was statistically significantly more affected in patients having multiple nails involved, women, and in people aged 60-79 years. There was no statistically significant difference on the QoL impact between patients having only fingernails or only toenails involved.

Even though published literature tends to focus on the impact of nail psoriasis and onychomycosis on QoL, other nail disorders cause similar frustration to patients. A possible explanation for this is that appearance of the nail has a more significant impact on QoL than the severity of the disorder.