Nails in older adults.

As the world's population of adults greater than 60 years old continues to increase, it is important to manage nail disorders that may impact their daily lives. Nail disorders may have significant impact on quality of life due to decreased functionality, extreme pain, or social embarrassment. In this review, we discuss nail disorders affecting older patients, including physiologic, traumatic, drug-induced, infectious, environmental, inflammatory, and neoplastic conditions. Diagnosis of these conditions involves a detailed history, physical examination of all 20 nails, and depending on the condition, a nail clipping or biopsy and/or diagnostic imaging. Nails grow even more slowly in older adults compared to younger individuals, and therefore it is important for accurate diagnosis, and avoidance of inappropriate management and delay of treatment. Increased awareness of nail pathologies may help recognition and management of nail conditions in older adults. Nail disorders are common amongst older adults and may cause decreased functionality, pain, psychosocial problems and impact quality of life.Many nail conditions, both physiologic or pathologic, may have similar presentation in older adults. Confirmation testing is important to avoid inappropriate or delayed treatment.The increased frequency of comorbidities, drug interactions, polypharmacy, and mental or physical limitations with aging must be considered when managing care of older patients with nail disorders.