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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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To have a better understanding of how onychomycosis affects the nail, a general knowledge of the anatomy of the nail is helpful (see Figure 1). The nail, or nail unit, consists of the following parts:

• The nail matrix (where the nail starts) is where nail cells multiply and keratinize (harden and form into nail material) before being incorporated into the fingernail or toenail. Most of the matrix is not visible. The matrix starts under the skin 5 mm below the nail fold (the area of the cuticle where the finger or toe skin meets the nail) and covers the area called the lunula, or half moon (the white half moon-shaped area at the bottom of the nail).
• The cuticle is a fold of modified skin where the finger or toe meets the nail. The cuticle protects the matrix from infection.
• The nail plate is the nail itself.
• The nail bed is the soft tissue underneath the nail, anchoring the nail plate. The nail plate protects the nail bed.

Figure 1: Anatomy of the nail; SOURCE: Medscape.com

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