Texas Cosmetology Operator Written ExamNail Care ServicesHard
A client requests a pedicure, and upon examining their feet, the technician observes several small, dark, splinter-like streaks under the nail plate. The client denies any recent trauma. What is the most likely cause of these streaks?
- AOnychomycosis
- BMelanonychia
- CPterygium
- DSplinter hemorrhages
Show answer & explanationAnswer & explanation
Correct answer: D. Splinter hemorrhages
Splinter hemorrhages appear as small, linear red or reddish-brown streaks under the nail plate. While they can be caused by trauma, in the absence of trauma, they can indicate underlying systemic conditions such as endocarditis or psoriasis, or even severe nutritional deficiencies. A cosmetologist should not diagnose, but recognize this as a condition requiring medical referral.
Why the other options are wrong
- A. Onychomycosis (nail fungus) typically causes discoloration (yellow, white, brown), thickening, and crumbling of the nail, not splinter-like streaks.
- B. Melanonychia presents as a black or brown band running the length of the nail, often due to pigment production.
- C. Pterygium is the forward growth of the eponychium over the nail plate, or the hyponychium over the nail plate, not streaks.
Splinter Hemorrhages
Tiny blood clots that run vertically under the nails, appearing as small, dark, splinter-like lines. Can be caused by trauma or underlying systemic diseases.
- Appear as thin, red/brown lines.
- Result from damaged capillaries under the nail.
- Can indicate trauma or systemic issues (e.g., endocarditis).
- Requires medical referral if no trauma is present.
Memory trick: Nail Clues: Streaks = Systemic Signals, See a Doc!