Nail Disorders, Diseases, and Client Contraindications
This domain tests whether you can separate cosmetic nail variations from conditions that require referral. Expect questions on onychomycosis, paronychia, onycholysis, Beau lines, and when to refuse service.
Core rules
- Disorders include ridges, leukonychia, koilonychia, onychorrhexis, onychogryphosis, and pterygium. Many are cosmetic, but sudden or painful changes need medical evaluation.
- Infections include fungal (onychomycosis), bacterial (paronychia), and viral (warts). Do not service infected, inflamed, swollen, or pus-filled tissue. Refer.
- Systemic clues include clubbing, splinter hemorrhages, a new dark streak (melanonychia), and yellow nail syndrome. Refer these rather than masking them.
- Contraindications include open lesions, fever, uncontrolled diabetes with circulatory compromise, and known allergy to acrylates or nickel. Clients on blood thinners need gentle technique and clearance when bruising is a risk.
- Green discoloration under an enhancement suggests bacterial colonization, often Pseudomonas. Remove the product if within scope, disinfect tools, and refer if pain or spreading occurs.
Worked example
A client has a green-black spot under an acrylic nail. Reasoning: trapped moisture and bacteria are more likely than fungus. Do not apply a new enhancement over it or claim to cure it. Refer for evaluation, clean and disinfect implements, and document the advice.
Traps
Assuming every discoloration is fungus, cutting cuticles to clean an infection, and promising a cure are mark-losers. Also do not diagnose; describe what you see and refer.