Ask Dr. Etingin: ANA Test; Fingernail Infection

My arthritis flare-ups have been more severe than usual, and bloodwork revealed a positive ANA (antinuclear antibody) test result. Now my doctor wants me to see a rheumatologist. What can this mean?

A positive ANA (antinuclear antibody) test can sound concerning, but it’s important to understand what it means—and what it doesn’t. ANA antibodies are proteins produced by your immune system that mistakenly target the body’s own tissues. While a positive result can indicate an autoimmune condition, it doesn’t necessarily mean you have one. Many healthy individuals, especially women over 50, may have a positive ANA without experiencing any symptoms or illness. However, your doctor’s recommendation to see a rheumatologist is a wise step, as rheumatologists specialize in autoimmune diseases and can help determine what’s going on.

A positive ANA test can be associated with conditions like lupus, rheumatoid arthritis, or Sjögren’s syndrome, which are more common in women. Symptoms such as joint pain, unexplained fatigue, rashes, or dry eyes and mouth can provide important clues. However, the ANA result is just one piece of the puzzle. A rheumatologist will likely ask about your symptoms, perform a physical exam, and may order additional tests to get a clearer picture.

It’s also worth noting that a positive ANA doesn’t always mean a serious condition is present. Sometimes, it can be a benign finding, especially as we age. Your visit to the rheumatologist is simply about gathering more information and ruling out potential concerns.

Don’t panic. Make a note of any symptoms, even if they seem minor or unrelated, and bring this information to your appointment. The goal is to ensure your long-term health and well-being, and seeing a specialist is an important step toward answers and peace of mind.

After a few months of getting acrylic nail manicures at a local salon, there is a suspicious dark spot under my nail. Is it an infection? And if so, how long will it take to resolve?

If you suspect an infection, it’s important to seek treatment promptly. While it may seem minor, untreated infections can worsen or spread, so seeing a dermatologist sooner rather than later is key to healing and preserving nail health. It’s not uncommon to develop a nail infection after regular acrylic manicures, as artificial nails can trap moisture underneath and create the perfect environment for bacteria or fungi to thrive. The type of infection—whether bacterial or fungal—will determine how long it takes to resolve and how it should be treated. If the spot is greenish brown, it may be Pseudomonas, a common bacterial infection found in moist environments, such as under artificial nails that have lifted. A dermatologist may prescribe topical or oral antibiotics to clear it up, and with proper treatment, it can resolve within a week or two.

Fungal infections, which can take longer to treat, often appear as thickened, discolored nails—yellowish, white, or even brownish— and they progress more slowly. A dermatologist will likely recommend an antifungal medication, which may include topical treatments or oral anti-fungals depending on the severity. Because nail fungus is notoriously stubborn, it may take several months for the nail to completely grow out and return to normal, even after the infection clears.

Regardless of the cause, the first step is to remove the acrylic nail to prevent further trapping of moisture and allow the area to heal. Keep the nail clean and dry, avoid nail polish until the infection resolves, and follow your dermatologist’s treatment plan closely. To prevent future infections, consider giving your nails a break from acrylics, ensure that any salon you frequent uses proper sanitation, and keep your nails trimmed.

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