What Causes Koilonychia?

Petroleum Exposure

Exposure of petroleum-containing products to an individual's nails over an extended duration can cause them to develop nail deformities, including koilonychia. The nail bed and nail matrix epithelial cells are both responsible for the formation of the nail plate, nail, and nail bed. The area underneath the nail plate and the nail fold are the most vulnerable areas when it comes to chemical exposure to an individual's fingernails. In the area of its free margin, chemical substances can penetrate underneath an individual's nail plate and nail bed. Most occupations involving exposure to petroleum-containing substances fall under the category of cosmetology, including hairdressers, beauticians, barbers, and nail technicians. Chemicals such as petroleum can also induce a condition called allergic dermatitis in the periungual skin regions, causing repeated inflammation to a patient's nail bed. Any chemical substance that results in an inflammatory response in an individual's nail matrix or nail bed can cause the nail to become distorted or deformed. Precautions should be taken by those who work closely with harsh chemicals that contain petroleum, such as wearing protective gloves on the hands.

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Higher Altitudes

Koilonychia can be caused by an individual's long-term residence at higher altitudes. The atmospheric air an individual breathes in becomes thinner as they go up in elevation from sea level. While the air technically contains the same 20.9 percent oxygen content at all elevations, the lower pressure at higher elevations decreases the amount of effective oxygen an individual is able to breathe in. For example, the amount of effective oxygen sits at 20.9 percent at sea level, and an elevation of five thousand feet above sea level only yields 17.3 percent effective oxygen. An elevation of ten thousand feet yields a further decreased 14.3 percent oxygen, which falls just below ten percent effective oxygen at an altitude of approximately twenty thousand feet. The body receives less oxygen at high altitudes, making less oxygen available for cells around the body. The body responds by increasing its production of red blood cells, causing a depletion in iron stores and resulting in iron deficiency anemia.

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