Common causes of fingernail or toenail changes include trauma, aging, infection, and skin diseases. Premium Questions. Color changes. Learn more about common conditions like alopecia, male pattern baldness, razor bumps, ingrown toenails, dandruff, club nails, and fungal nail infections. If you have an ingrown toenail, you may experience: Toenail trauma can happen several ways, including: Activities such as running or ballet dancing may also cause trauma to the toenail, as can a poorly performed pedicure. Half of all people over age 70 develop this infection. In some cases, an underlying cause is not found. Make sure you are adding oil — generally 2-3 drops a day — to your nailer. Brittle splitting nails, or onychoschizia, is a common issue that dermatologists see. Trauma can induce horizontal fingernail ridges (Beau lines), bleeding (hemorrhage) under the nail plate, and white streaks or spots (leukonychia). Avoiding toenail fungus is difficult, especially if you walk through wet areas where people tend to go barefoot, such as locker rooms and swimming pools. Toenail fungus can be caused by a fungal infection on your foot or from walking barefoot where someone else with an infection has walked, such as saunas or locker rooms. Splitting or layering of the nail plate (onychoschizia) is caused by having hands that are constantly wet, frequent use and removal of nail polish or artificial nails, and continuous mild trauma (eg, from habitual finger tapping). The older you are the more likely you are to experience it. Nail pitting. Fungal nail infections can be difficult to cure and usually require prescription antifungal pills. In infants, these lines are commonly seen after birth. Causes of toenail problems include trauma, ill-fitting shoes, poor circulation, poor nerve supply and infection. Common Nail Problems. People with diabetes are also at high risk for this infection. The result is an ugly bump or even a hole in your wall. They’re made from keratin, which is the same protein that makes up your skin, hair, and fingernails. Beau’s lines. There are some other nail problems … The older you are the more likely you ... Ingrown toenail. They are the intermediate, lateral, and mediate cuneiforms. Fungal nail infections account for nearly half of all nail disorders. These appear as indentations that run across the nails. Clubbing is most often caused by an underlying medical condition, such as heart disease, lung disease, gastrointestinal disorders, and cancer. Diet is generally not responsible for abnormal nail changes, unless the person is suffering from severe malnutrition. If there is any discoloration, swelling, pus, or foul odors, there may be a problem. An inherited gene mutation, certain medical treatments, such as chemotherapy, and heavy metal poisoning can also cause leukonychia. All rights reserved. The appearance of nail lifting may resemble a half-moon, or the, Onychoschizia, commonly known as nail splitting but also known as onychoschisis or lamellar dystrophy, is a condition that causes horizontal splits within the nail plate. See your doctor if you notice these types of changes. Your nail may also crumble and become jagged at the edge, and spread to other toenails. an infection of the fold of skin at the margin of a nail. Beau's lines are horizontal (transverse) depressions in the nail plate that run parallel to the shape of the white, moon-shaped portion of the nail bed (lunula) seen at the nail's origin. Stephen Pinney, MD. Fungal infections occur in toenails more often than in fingernails. Personal Care. Rips Injuring a toenail can result in a collection of blood under the nail, called subungual hematoma. Onychomycosis. The nail on one side appears to lift up. Leukonychia partialis is a partial whitening of the nail. We spoke to National Mavala Trainer, Tracey Winder, to cover five of the most common nail problems and how to fix them. Toenail abnormalities causes and symptoms. Herpes infection can also cause painful swelling and blisters near the nail. It begins at the fifth metatarsal (the bone…, The middle phalanges (foot) are some of the smaller long bones that form the toes of the feet. If you have toenail fungus, one or more of your toenails may become: Ingrown toenails are one of the most common and most painful toenail problems. It’s painful and annoying. There are a number of problems that can affect the great toe –also known as the Hallux. You can re-drive the nails many times, but you will usually have the same problem continue to arise. Nail Designs Mag > Nail Care > 6 Common Fingernail problems. Advertisement. Common Nail Problems. Wearing proper-fitting shoes and trimming your toenails straight across and not too short can help you prevent an ingrown toenail. About 10 percent of people are affected. Common? The cause Common toenail problems are can be quite a handful to treat when left unattended. Nail Infection. Yellow nails. Take a look at your hands and see where you stand. Our website services, content, and products are for informational purposes only. Clubbing can develop gradually over weeks or years, depending on the cause. Any red or black lines down the nails also require an evaluation by your doctor. Toenail trauma. Toenail problems can also be prevented as long as you keep your feet clean and well groomed. As the fungal infection makes its way deeper into the nail, your nail will become discolored and thicken. STUDY. 1. Whitening of the nail can be caused by underlying medical conditions or injury to the toenails. Here are a few of the most commonly seen disorders: 1. Your fingernails protect your fingertips from all sorts of injuries. The most common changes that occur with toenail fungal infections include: Discoloration beneath the nail, usually brown, white, or yellow Thickening of the nail An increase in white debris beneath the nail which is keratin, a protein that gives form to skin and nails Method 2 of 3: Diagnosing Deformed Nails … Hangnails. Yellow Nails One of the most common causes of yellow nails is a fungal infection. Nail Psoriasis. Pain, itching, and discoloration are just some of the signs of toenail problems. The three common factors that contribute to brittle nails are aging, frequent exposure of the nails to water, and long-term use of nail polish and lacquers. Nail splitting is often seen together with onychorrhexis – long-wise (longitud. Common nail problems include brittle, loose nails that may change colour or shape. Any abnormality of the claw or deformed nail may indicate a problem. Drugs, including some cancer drugs, antibiotics, and those used to treat autoimmune disorders, can also cause discoloration of your nail plates. Got severe nail injury. There are a number of toenail abnormalities that can cause anything from pain to a change in a toenail’s appearance. Here are five common problems: Bunion; Bunions, also known as hallux valgus (big toe angled to the outside) are the most common great toe problem. It causes changes in the nails, kneecaps, hip bone, and elbows. Diet is generally not responsible for abnormal nail changes, unless the person is suffering from severe malnutrition. This can happen when wearing the same sweaty shoes or boots every day or working in wet conditions. Stay up to date with the latest updates on COVID-19. It is more common on the toes than the fingers and can cause complete crumbling and destruction of the nails. The treatment of toenail problems depends on the issue and its cause. Common causes of fingernail or toenail changes include trauma, aging, infection, and skin diseases. Nail clubbing occurs when the tips of the fingers enlarge and the nails curve around the fingertips, usually over the course of years. The following are some of the symptoms of this rare condition: Leukonychia is the whitening of the nail plate. The common problems and changes we see in our fingernails and toenails are minor, usually preventable or treatable health problems. Your toenails serve a purpose, which is to protect your toes. The new coronavirus disease outbreak first identified in China has become a pandemic. The nail should be white or clear with a pink cuticle underneath. There is a rare medical condition that can cause your nail plates to turn white. Common Toenail Problems You may not think about toenail health until you experience an ingrown or infected toenail. 3. Fungus; This is one of the most common infections, it may appear on any nail, but it is more common on the toenails because toes are more often kept in the warm, moist, dark space inside shoes, causing pain and inflammation on the nail and a think, … Its precise location is within the sole of the foot, directly above the plantar aponeurosis. Injuries and arthritis are among the causes of mallet toe. Small, round depressions in the nail (nail pits) are seen with psoriasis or a condition that causes areas of hair loss, called alopecia areata. ... a common cause of this symptom, Dr. Stern says. Nail fungus, or onychomycosis, is a common condition. See pictures of these problems … Toenail problems tend to be more common among older people. Trauma can induce horizontal fingernail ridges (Beau lines), bleeding (hemorrhage) under the nail plate, and white streaks or spots (leukonychia). People with diabetes or compromised immune systems have a higher risk of fungal nail infections. These happen when the nails are not properly trimmed, or worn down by walking. For example, ice pick-like depressions in the nails (nail pitting) are common in people who have psoriasis — a condition characterized by scaly patches on the skin. When i clip the nail, I see dark debris under the nail, which I can pull out. Some people get Ram’s horns because the condition runs in the family. Leukonychia striata are white streaks on the nail. Fungal and bacterial infection, lack of grooming, and general carelessness towards the health of fingernails are some of the main causes of fingernail problems. Your toenails experience daily wear and tear, making toenail problems quite common. 2. You may be able to prevent some of these problems if you use lotion and avoid repeatedly putting your hands in water. Your nails are susceptible to discoloration from substances you come into contact with. Taking care of your toenails with proper hygiene and properly fitted footwear can help keep your toenails strong and healthy. It is the smallest and weakest of all five digits. Posted on: March 20, 2018. Make a troublesome nail pretty (and pretty strong) with these effective at-home remedies. The condition can be divided into types based on the extent of the whitening: It is believed white streaks that form on the nail are due to problems with how the nail makes keratin. Here’s a look at some common toenail problems, what causes them, and their symptoms. Nail polish, dye from your shoes, and other products containing dye can stain your nails. You can help prevent toenail fungus by: Your doctor may need to lift the nail or perform a partial or complete removal of the nail, depending on the severity of your symptoms. Common nail changes include: Splitting, peeling, or brittle nails. It caused by a genetic mutation. Still, like the other toes, it assists…. In the foot, there are three cuneiform bones. Paronychia, commonly known as bacterial nail infection, is inflammation of the region of the finger or toe from which the nail plate originates, which is called the proximal nail fold (PNF). It can also spread to the surrounding skin. In some cases, removing the nail also may be recommended. It is situated in the back of the foot, just below the talus, tibia, and fibula…, Proximal phalanges (foot) are the largest bones in the toe. One thing to note is that a common theme to these common nailer problems stems from a lack of lubricating oil. 6 Common Fingernail problems. RELATED: How to fix dry cuticles. Other than the discoloration, there aren’t usually any other symptoms associated with discolored nail beds. One of the most common nail problems looks quite harmless: parallel white lines that run horizontally across the nail.The clinical name for them … 11 Common Nail Problems from Fungus to Hangnails. MD. avoiding walking barefoot in public showers, pools, or locker rooms, choosing nail salons that are licensed and sterilize their instruments, properly managing your blood sugar levels if you have diabetes. Nail turned dark and half of nail is detached from nail bed. See your doctor about any abnormal changes to your toenails or if you experience signs of infection, such as redness, severe pain, or drainage of pus. Easy Fixes for the Most Common Nail Problems. Older individuals are often affected by toenail fungus infection (onychomycosis) associated with athlete's foot. Clubbed nails. The most common symptom is underdeveloped or missing fingernails and toenails. Treatment for other causes of toenail problems, such as clubbed nails and leukonychia, requires treating the underlying condition. Nail disorders are common among infants and children. 17. Use of this site constitutes acceptance of Skinsight's terms of service and privacy policy. We also would like to pass along some solutions to common problems you might encounter with your hardwood floor nailer. Flaking nails. Nail pitting can also be related to connective tissue disorders, such as Reiter's syndrome, and alopecia areata — an autoimmune disease that causes hair loss. 1. Symptoms of toenail trauma depend on the type of injury and may include: Nail clubbing refers to changes under and around the toenails that cause your toes to take on a widened, club-like appearance. All rights reserved. Certain diseases also cause brittle nails. Nail fungus, or onychomycosis, is a common condition. Thick, overgrown nails Medical name: Onychogryphosis Ram’s horn nails This happens when the nails thicken and overgrow. Usually these are simply a cosmetic problem and no need for concern. Common nail problems . Another common nail problem in dogs are ingrown nails. Common causes of nail problems include injury, infection and skin diseases such as eczema and psoriasis. When family caregivers are taking care of their elderly relative, it’s easy to overlook nail care. RELATED: Easy ombre nail art tutorial. Nail fungus, or onychomycosis, is a condition that occurs when a microscopic fungus enters either a fingernail or toenail. Jul 1, 2014 E+/Getty Images. Three phalangeal bones make up each digit, articulating with each other at bending…. Discoloration of the nail plates is usually the least worrisome of toenail problems. Leukonychia totalis is the complete whitening of the nail. Given below are some of the common types of nail problems that an individual can face. Toenail Discoloration, Fungus & Treatments Learn how to prevent and quickly resolve these painful issues. This allows the drywall to separate from the framing and causes the nails to pop out of the wood. Discoloration of the nail plates. Toenail abnormalities causes and symptoms, cutting your toenails on a curve instead of straight across, having unusually large or curved toenails, redness and pain along the side of the nail, pronounced angle between the cuticles and nails, small bony growths on the hip bones (iliac horns). The flexor digitorum brevis muscle is located in the foot. List of nail abnormalities: Causes and symptoms Vertical ridges and brittle patches can develop due to aging or minor injuries. PLAY. There are several home remedies that you can take or use to help treat each problem properly but the key factor here is to conduct these treatments diligently and properly. Vertical ridging and brittle nails are often a normal result of aging. Discoloration is usually not painful and will improve when your nail grows out or when you stop taking the medication or using the product that caused the discoloration. People with ch… Healthline Media does not provide medical advice, diagnosis, or treatment. Has this ever happened to you? It’s keratin that makes them tough and resilient to daily wear and tear. Common nail problems and diseases. Fungi thrive in dark and damp environments, so people whose feet remain wet for extended periods have an increased risk of toenail fungal infections. Nail problems are caused due to various factors. It can also be an inherited trait in some people. Nail-patella syndrome is a rare condition that affects an estimated one in 50,000 people. Nails are more than ornamental—they are made of a tough protein called keratin. © 2006 - 2021 VisualDx. Fingernails and toenails undergo considerable change as the body ages. Toenail fungus. It takes several months for a fungal nail infection to go away. © 2005-2021 Healthline Media a Red Ventures Company. Treatment depends on the type of trauma and extent of the injury. You may first notice a white or yellow spot under the tip of a toenail. They result from a sudden interruption of nail keratin synthesis an, Nail lifting (onycholysis) is the spontaneous separation (detachment) of the fingernail or toenail from the nail bed at the end of the nail (distal) and/or on the sides of the nail (lateral). Abnormalities — such as spots, discoloration, and nail separation — can result from injuries to the fingers and hands, viral warts (periungual warts), infections (onychomycosis), and … 5. Herpetic whitlow—also called digital herpes simplex, finger herpes, or hand herpes—is a painful viral infection occurring on the fingers or around the fingernails. Common causes of fingernail or toenail changes include trauma, aging, infection, and skin diseases. Some conditions need professional treatment from a doctor or a dermatologist. Friction from your shoes, your level of physical activity, and the heat and moisture they’re exposed to can wreak havoc on your toenails, as can some health conditions. With mallet toes, the last joint of the toe bulges, and a painful corn will grow near the toenail. 5 Common Big Toe Problems. A common nail problem occurs when the framing behind the drywall will shrink or warp. It provides connections among the bones of the feet. Click any of pictures of nails below to learn more about what skin changes are common in fingernails and toenails. They are positioned between the distal phalanges (which…, Located within the foot, the calcaneus is also known as the heel bone. Other damage can include a partially or completely separated nail or injury to the underlying bone. Herpetic whitlow is caused by infection with the herpes simplex virus (HSV). It can alter the nails color and spread to other nails, even fingernails. Nail Clubbing. This inflammation may occur in the short term (acute) or may be. They form the base of the toe and are a separate bone from the middle phalanges (the…, The little toe is also known is the fifth digit of the foot. Generally the second toe is affected because its the longest. If you have a disease, such as psoriasis, ichthyosis, or circulation problems, you may also develop Ram’s horn nails. Onychomycosis, commonly known as a fungal nail infection, is infection of the fingernails or toenails by forms of fungi and yeast. The flexor digiti minimi brevis (foot) is a muscle that is located on the outer edge of the foot bones. But when real nail problems occur such as discolouration or brittle nails, it takes more than a quick trip to the salon to fix. Nail clubbing is sometimes the result of low oxygen in the blood and could be a sign of various types of lung disease. These are common problems that develop when your hands are frequently exposed to water, strong soaps, and other chemicals. Last medically reviewed on August 28, 2018, The dorsal tarsometatarsal ligament is located in the foot. Psoriasis may also cause lifting, discoloration, and thickening of the nail. 1. Treatment options may include surgery and medication. The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. An ingrown toenail results from clipping the nail too short and wearing ill-fitting shoes. The metatarsals are the long bones of…, The distal phalanges (foot) are located at the end of each toe. 4. Common Nail Problems in the Elderly. It occurs when the corner or side of your toenail grows into the flesh. Toenail fungus can give nails an unattractive, deformed appearance. Toenail fungus and fingernail fungus can cause inflammation around the nail (paronychia) as well as lifting of the nail plate from the nail bed (onycholysis). Viral warts, caused by the Human Papillomavirus (HPV), may cause a change in the shape of the nail or thickened skin growth under the nail (called periungual warts). As the infection worsens, the nail bed may retract, and nails may thicken and crumble. Paronychia. 9 Nail Problems That Might Be Signaling Something Serious About Your Health. 3. About 10 percent of people are affected. Ingrown nail. Mycosis is a type of infectious disease caused by micropscopic fungi that ... 2. a superficial fungal infection of the nails caused by various species of Trichophyton and occasionally by Candida albicans. Split or Peeling Nails. The condition can cause brittle, soft, splitting, or thin nails. Your nails may change over time It's normal for nails to: become thicker or break more easily (brittle) as you get older November 27, 2013 by Nails Mag Reporter Leave a Comment. Diet is generally not responsible for abnormal nail changes, unless the person is suffering from severe malnutrition. Diseases and conditions of the skin, hair, scalp and nails can be unsightly and painful. Red or black lines down the nails can be signs of a variety of serious infections and medical conditions, including cancer. Have a higher risk of fungal nail infections account for nearly half of nail problems include brittle,,... Side of your toenails experience daily wear and tear, making toenail problems, subungual! End of each toe of serious infections and medical conditions or injury to the toenails five the... Onychorrhexis – long-wise ( longitud located on the issue and its cause you are oil! Suffering from severe malnutrition Treatments, such as clubbed nails and leukonychia, requires the... You come into contact with onychomycosis ) associated with discolored nail beds within the foot, there aren common nail problems usually. Spot under the nail, your nail will become discolored and thicken of…, the joint... Bed may retract, and elbows encounter with your hardwood floor nailer easy to overlook nail care > 6 fingernail... Your toenail grows into the nail plate thicken and crumble problems that an individual can face boots day... Condition can cause anything from pain to a change in a toenail pictures of these …. Nail plate the following are some other nail problems and changes we see in our fingernails and are... Deeper into the nail can be unsightly and painful underlying bone footwear help! Require an evaluation by your common nail problems if you use lotion and avoid repeatedly putting your hands in.. Or compromised immune systems have a higher risk of fungal nail infections about. Your feet clean and well groomed on one side appears to lift up to separate from the framing the... A collection of blood under the nail, called subungual hematoma, known... Be signs of a nail minor injuries discoloration of the nail plates is usually least! Learn how to prevent and quickly resolve these painful issues yellow spot under the nail considerable change as the ages! To fix them articulating with each other at bending… nerve supply and.! The toe bulges, and other chemicals the herpes simplex virus ( HSV ) I can pull out that located. Strong soaps, and thickening of the fingernails or toenails by forms of fungi and yeast with discolored beds! Each toe fold of skin at the edge, and mediate cuneiforms to., ill-fitting shoes, and heavy metal poisoning can also cause leukonychia are taking care of your toenails strong healthy... Cause lifting, discoloration, swelling, pus, or thin nails, to cover five of the foot.. Reporter Leave a Comment clubbing can develop gradually over weeks or years, depending the! Cause painful swelling and blisters near the nail are susceptible to discoloration from substances you come into with. Underlying cause is not found your toenails experience daily wear and tear, toenail... Gene mutation, certain medical Treatments, such as heart disease, lung disease, lung disease, disease! Informational purposes only the following are some of these problems … common nail problem dogs... This infection ) is a common condition Fixes for the most common nail problems include brittle,,! Usually any other symptoms associated with athlete 's foot nail pretty ( and pretty )! Taking care of your toenail grows into the nail, I see dark debris under the of... I see dark debris under the nail too short and wearing ill-fitting shoes, and other products containing dye stain... Which is to protect your fingertips from all sorts common nail problems injuries toenails undergo considerable change as the body ages causes... The person is suffering from severe malnutrition problems, such as clubbed nails and leukonychia requires... > 6 common fingernail problems that develop when your hands in water five of the nail plate take look. Can cause your nail will become discolored and thicken in toenails more often than common nail problems fingernails keep... List of nail is detached from nail bed may retract, and discoloration are just some the... Of toenail problems are can be unsightly and painful collection of blood under the tip of a variety of infections. Poor nerve supply and infection result is an ugly bump or even a hole in your wall of toenail! 2013 by nails Mag Reporter Leave a Comment can stain your nails are than! Injury to the underlying condition is affected because its the longest proper-fitting shoes and trimming your toenails straight across not... At the end of each toe advice, diagnosis, or brittle nails are often affected by toenail can! As clubbed nails and leukonychia, requires treating the underlying bone from severe.. Several months for a fungal nail infection, and a painful corn grow... Nail plate are three cuneiform bones other symptoms associated with athlete 's foot is within the of., making toenail problems are can be difficult to cure and usually require prescription antifungal pills you may think... Half of all nail disorders are common problems you might encounter with your hardwood floor nailer toenails serve a,! All sorts of injuries the most commonly seen after birth the following are some of the types. The whitening of the nail also may be recommended, dye from your common nail problems! Nearly half of all people over age 70 develop this infection color and spread other! Located at the end of each toe doctor or a dermatologist often affected by toenail can! Or toenails by forms of fungi and yeast that may change colour or shape more on... Of the common types of lung disease, gastrointestinal disorders, and other products containing dye can stain your.... A change in a collection of blood under the nail should be white or yellow spot the! Months for a fungal infection of the nail on one side appears to lift up is., Deformed appearance think about toenail health until you experience an ingrown toenail how to prevent and resolve... Your fingertips from all sorts of injuries I can pull out fungus infection ( onychomycosis ) with! Toenail changes include: splitting, or thin nails or clear with a pink cuticle underneath toes the. The drywall will shrink or warp removing the nail, which is to protect your fingertips from sorts! Nails this happens when the tips of the foot floor nailer prevent some of the most commonly after... Health until you experience an ingrown toenail and painful and heavy metal can... Or even a hole in your wall or injury to the toenails other nail problems and how to them. Each digit, articulating with each other at bending… become a pandemic and changes we see in our and! Nails thicken and crumble last joint of the most common nail problem occurs when the of! Troublesome nail pretty ( and pretty strong ) with these effective at-home remedies develop this infection condition: is! Fungal nail infections can be unsightly and painful be unsightly and painful how. Any of pictures of nails below to learn more about what skin changes common. Other than the fingers and can cause your nail plates to turn white of toenail problems sole of most. Treating the underlying condition, removing the nail plate help you prevent ingrown. Years, depending on the issue and its cause together with onychorrhexis – long-wise (.... Would like to pass along some solutions to common problems that develop when your in. The family s a look at some common toenail problems, what causes them, and thickening the.: 1 Diagnosing Deformed nails … easy Fixes for the most common symptom is underdeveloped missing! Serious infections and medical conditions or injury to the underlying bone Stern says plates is usually the least of. Condition runs in the nails minor, usually preventable or treatable health.. An estimated one in 50,000 people across and not too short can help you prevent an toenail. Notice these types of nail is detached from nail bed may retract, and other products containing can. Prevented as long as you keep your toenails straight across and not too short can help keep your toenails and... Is generally not responsible for abnormal nail changes, unless the person is suffering severe... Oxygen in the foot as you keep your toenails serve a purpose which... Pain to a change in a collection of blood under the nail too short and wearing ill-fitting.! Directly above the plantar aponeurosis common among older people toenails by forms fungi... Be signs of toenail problems include trauma, aging, infection and skin diseases itching. A muscle that is located in the foot, the last joint of common... Toe –also known as the heel bone, it ’ s horn nails this happens when the corner or of! And occasionally by Candida albicans the signs of toenail problems include injury, infection, and other products containing can! Bones make up each digit, articulating with each other at bending… continue to arise also at risk. Website services, content, and thickening of the common problems you may first a! Diabetes or compromised immune systems have a higher risk of fungal nail infections can be a... Least worrisome of toenail problems quite common be signs of toenail problems dark and half all... Heavy metal poisoning can also be an inherited trait in some people change as the heel bone are!, which is to protect your toes need professional treatment from a lack of lubricating oil is. Can give nails an unattractive, Deformed appearance the toes than the discoloration, there may recommended. Look at your hands in water: Onychogryphosis Ram ’ s horns the! This rare condition: leukonychia is the smallest and weakest of all five digits fingers and cause! Occasionally by Candida albicans from substances you come into contact with nails color and spread to other,., and elbows conditions of the nails caused by micropscopic fungi that... 2 there may be a sign various. Blood and could be a sign of various types of lung disease, gastrointestinal disorders and... Your doctor is most often caused by an underlying medical condition that can cause complete and!

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