An Integrative Review of Nail Disorders: Correlating Unani Concepts with Contemporary Clinical and Dermatological Frameworks
Abstract
Background: Nails have important functional and cosmetic roles, and their alterations may indicate underlying local or systemic diseases. Nail disorders can significantly affect quality of life. In Unani medicine, nails (Aẓfār) are regarded as important diagnostic indicators with both aesthetic and pathological significance, reflecting underlying humoral imbalances (Akhlāṭ), alterations in temperament (Mizāj), and nutritional deficiencies; however, their correlation with contemporary dermatological concepts remains limited.
Objective: To analyse classical Unani descriptions of nail disorders and correlate them with contemporary dermatological entities.
Methods: An integrative literature review was conducted using the Whittemore and Knafl framework and reported as per PRISMA 2020 guidelines. Data were obtained from PubMed, Scopus, Google Scholar, and classical Unani texts including Al-Qānūn fi’l Ṭib, Kitab al-Mansoori and Kāmil al-Ṣanā‘a etcs. Relevant studies were analysed using thematic and comparative synthesis.
Results: Unani literature describes nail disorders such as Ẓufra Ṭalqiyya, Namash al-Aẓfār, Judhām al-Aẓfār, Tashaqquq al-Aẓfār, Taqallu‘al-Aẓfār, and Dākhis, presenting with discoloration, brittleness, deformity, and inflammation. These are mainly attributed to Sawdāwī predominance and nutritional defects. Modern correlations include brittle nail syndrome, leukonychia, onychomycosis, nail dystrophy, onycholysis, paronychia, and subungual hematoma.
Conclusion: A substantial conceptual overlap exists between Unani and modern dermatology. Integrating both perspectives may enhance diagnosis and holistic management of nail disorders.
Keywords: Nail disorder, Integrative Dermatology, Onychomycosis, Onychpathies, Unani medicine, Nail dystrophy
Keywords:
Nail disorders, Integrative dermatology, Onychomycosis, onychpathies, Unani medicine, Nail dystrophyDOI
https://doi.org/10.22270/jddt.v16i6.7756References
1. Cranwell W, Sinclair R. Male androgenetic alopecia.dsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. Fitzpatrick’s Dermatology in General Medicine. 8th ed. Vol 1. New York: McGraw-Hill Companies; 2012: 965-966
2. Al-Qānūn fi’l Ṭibb. Ibn Sina. (Urdu translation by Kantoori GH). Vol 1. New Delhi: Idara Kitab-ul-Shifa; YNM: 1407-0.52-53
3. Baghdādī AIH.Kitāb al-Mukhtārāt fi’l Tib (Urdu translation by Central Council for Research in Unani Medicine).Vol.1.New Delhi: CCRUM; 2005:103.
4. Majūsī AIA.Kāmil al-Sanā (Urdu translation by Hakim Ghulam Husnain Kantoori).Vol 1. New Delhi: Idāra Kitāb al-Shifā; 2010:111-112.
5. Baran R, Dawber RPR, Haneke E. Baran and Dawber’s diseases of the nails and their management. 4th ed. Oxford: Wiley-Blackwell; 2012.1-25.
6. Nafis ibn Awad Kermani H. Kulliyat-e-Nafisi. Lahore: Idara Matbuat Sulemani; 2007.136
7. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Elsevier; 2016.1048-1052
8. Lipner SR, Scher RK. Nail disorders: part of the American Academy of Dermatology core curriculum for medical students. J Am Acad Dermatol. 2019;80(4):1231-1238. https://doi.org/10.1016/j.jaad.2018.11.065 PMid:30682392
9. Tyagi M, Singal A. Nail cosmetics: what a dermatologist should know. Indian J Dermatol Venereol Leprol. 2024; 90:178-185. doi:10.25259/IJDVL_77_2023 https://doi.org/10.25259/IJDVL_77_2023 PMid:37317711
10. Dalave K, Raman T, Patil P, et al. A clinico-histopathological study of nail dermatoses in a tertiary care hospital. Cureus. 2024; 16(8):e67128. doi:10.7759/cureus.67128 https://doi.org/10.7759/cureus.67128
11. Dhingra G, Ahmad N, Tanwar S, Goyal S, Chaturvedi V, Tanwar K. Nail disorders: an updated review. Int J Pharm Sci Rev Res. 2022;75(2):135-144. doi:10.47583/ijpsrr.2022.v75i02.022 https://doi.org/10.47583/ijpsrr.2022.v75i02.022
12. Lee DK, Lipner SR. Optimal diagnosis and management of common nail disorders. Ann Med. 2022;54(1):694-712. doi:10.1080/07853890.2022.2044511 https://doi.org/10.1080/07853890.2022.2044511 PMid:35238267 PMCid:PMC8896184
13. Reinecke JK, Hinshaw MA. Nail health in women. Int J Womens Dermatol. 2020;6(2):73-79. doi:10.1016/j.ijwd.2020.01.006 https://doi.org/10.1016/j.ijwd.2020.01.006 PMid:32258335 PMCid:PMC7105659
14. Ibn Zuhr. Kitab al-Taysir fi al-Mudawat wa al-Tadbir (Urdu translation). New Delhi: Central Council for Research in Unani Medicine (CCRUM); YNM. 225.
15. Qamri AMH. Ghina Muna (Urdu translation Minhajul Ilaj). New Delhi: CCRUM; 2008: -471-473.
16. Relhan V, Bansal A. Acute and chronic paronychia revisited: a narrative review. J Cutan Aesthet Surg. 2022;15(2):125-132. https://doi.org/10.4103/JCAS.JCAS_30_21 PMid:35655642 PMCid:PMC9153310
17. Shafritz AB, Coppage JM. Acute and chronic paronychia of the hand. J Am Acad Orthop Surg. 2014;22(3):165-174. https://doi.org/10.5435/JAAOS-22-03-165 PMid:24603826
18. de Berker D. Nail disorders. In: Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook’s Textbook of Dermatology. 9th ed. Oxford: Wiley-Blackwell; 2016. 65.1-65.30.
19. Ibn al-Quff al-Masihi IADAF. Kitabul- umdah fi’l Jarahat. Vol. 2. New Delhi: Central Council for Research in Unani Medicine; 2010, p. 25-28.
20. Razi ABMBZ. Al Hawi (Urdu Translation by CCRUM). Part 1, Vol 17. New Delhi: CCRUM, Ministry of Health and Family Welfare, Govt. of India; 2007: 36-46.
21. Baran R, Dawber RPR, Haneke E, et al. Baran and Dawber’s Diseases of the Nails and their Management. 5th ed. Oxford: Wiley-Blackwell; 2019. 662-670.
22. Gupta AK, Versteeg SG. Onychomycosis: diagnosis and management. Clin Dermatol. 2017;35(2):157-304.
23. Haneke E. Surgical treatment of nail disorders. Dermatol Clin. 2006;24(3):417-425. https://doi.org/10.1016/j.det.2006.03.007 PMid:16798426
24. Arzani A. Tibbe Akbar. Deoband: Faisal Publications; YNM: 750-752.
25. Piraccini BM, Alessandrini A. Brittle nails: pathogenesis, clinical features, and management. Dermatol Ther. 2012;25(6):496-515.
26. van de Kerkhof PCM, et al. Brittle nail syndrome: a pathogenesis-based approach. J Am Acad Dermatol. 2005;53(4):644-651. https://doi.org/10.1016/j.jaad.2004.09.002 PMid:16198786
27. Bolognia JL, Schaffer JV, Cerroni L. Dermatology. 4th ed. Philadelphia: Elsevier; 2018. 1225-1255.
28. Maldonado F, Ryu JH. Yellow nail syndrome. Curr Opin Pulm Med. 2009; 15(4):371-375. https://doi.org/10.1097/MCP.0b013e32832ad45a PMid:19373089
29. Hippocrates. Moʿālajāt Buqrāṭiyya. Translated by Abu Hasan Ahmad ibn Muhammad al-Tabari. New Delhi: Central Council for Research in Unani Medicine; 2010. 343-354.
30. Grover C, Bansal S. Nail disorders: clinical approach. Indian J Dermatol Venereol Leprol. 2015; 81(3):231-243.
31. Simon RR, Wolgin M. Subungual hematoma: association with fracture and treatment. J Emerg Med. 1987; 5(3):201-204. https://doi.org/10.1016/0735-6757(87)90356-1 PMid:3593496
32. Rigopoulos D, Largos G, Gregoriou S, Alevizos A. Acute and chronic paronychia. Am Fam Physician. 2008; 77(3):339-346.
33. Rockwell PG. Acute and chronic paronychia. Am Fam Physician. 2001;63(6):1113-1116.
34. Chessa MA, Iorizzo M, Richert B, et al. Pathogenesis, clinical signs and treatment recommendations in brittle nails: a review. Dermatol Ther. 2020; 33(6):e14067.
35. Jurjani AH. Zakhira Khwarzim Shahi (Urdu translation by Khan HH). Vol 6. New Delhi: Idara Kitabul Shifa; 2010: 58-60.
36. Razi ABMBZ. Kitab al-Mansoori. New Delhi: CCRUM, Ministry of Health and Family Welfare, Govt of India: 1991: 195-208
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Copyright (c) 2026 Shaikh Mohammad Aatif Afzal , Khan Shahina Bano Mohd Vakeel , Madeena Kausar , Mohd Arshad Jamal

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