Deformities, dystrophies, and discoloration of the nails

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The terms deformities and dystrophies are often used interchangeably, sometimes even by doctors. However, their meanings are slightly different.

Deformities: Changes in nail shape
Dystrophies: Changes in nail texture, color, or both

Doctors more commonly use the term dystrophy than deformity. (See also Overview of Nail Disorders.)
About 50% of nail dystrophies are caused by a fungal infection (onychomycosis) . The remainder result from various causes, including nail injuries, birth deformities of the nails, psoriasis, lichen planus, and occasionally tumors (cancerous and noncancerous). Drugs, infections, and diseases can cause discoloration of the nails (chromonychia). For example, infection with Pseudomonas bacteria can cause a greenish discoloration (see Green Nail Syndrome).
The doctor can often make the diagnosis of nail dystrophies caused by a fungus by examining the nails. However, to confirm the diagnosis, the doctor may need to take fungal scrapings and do a culture (the process of growing the organisms in a laboratory) or do a polymerase chain reaction (PCR) analysis to look for genetic material from a fungus.
To diagnose nail dystrophies that are not caused by a fungus, doctors may do a biopsy of the nail plate (the hard part of the nail) or nail matrix (located at the base of the nail and where nail growth originates).
If the nail’s appearance does not improve with treatment of the underlying disorder, manicurists may be able to hide deformities and some dystrophies with appropriate trimming and polishes.