Why a new journal?

As we launch the Journal of Onychology and Nail Surgery (JONS), I am sure this question is coming to the minds of many of our readers. Do we really need a journal devoted to nails? Is this a sustainable venture? Is there enough science to support this journal?

Believe me; these questions nagged us enough at the Nail Society of India (NSI) before we decided to take this affirmative action and commit to launching and supporting the world’s first journal, exclusively devoted to nail in health and disease. This is because NSI itself is firmly founded on the belief that nail disorders deserve more attention than they are currently getting in medical science. Nails form an integral part of an individual’s ‘complete physical, mental and social well-being’, which is the World Health Organisation’s definition of ‘Health’.^[1] Even the extended definition of health as ‘the dynamic balance of physical, mental, social and existential well-being in adapting to conditions of life and the environment’^[2] envisages an important role of nail health. Clearly, we cannot ignore this aspect of human health, and who better to realise and relate to this concept, than a dermatologist?

Onychology is an emerging organised science, focussing on the nail as a specialised epidermal appendage.^[3] As of today, it stands as a super-specialised field, practised and researched by dermatologists worldwide. For long, nails have been considered a vestigial structure in humans, without much effort being put into understanding their structure and function. This perception does much disservice to the fact that individuals attach a lot of importance to healthy nails. It also undermines the evolutionary importance of the nails, whose shape and growth pattern has aided the development of our manual dexterity,^[4] including the uniquely human functions of cutting, crushing, gripping, clinging, and writing.^[5] Nails have long been organs of defence as well as offence. Scratching has given us a survival advantage by dislodging ectoparasites from the skin. Nevertheless, our understanding of the human nail has been rapidly evolving of late, with focussed research by dedicated researchers in this field. This has led to major advancements in onychology over the past few decades, much more than those over the past many centuries. Thus, it becomes pertinent to organise a platform for sharing and dissemination of research activities and knowledge in this field. It is important to recognise that all nail disorders are not onychomycosis. We now have a plethora of diagnostic and treatment modalities available in onychology. We hope that JONS will be that leading light for nail research across the world. With an illustrious editorial board, comprised of the ‘who’s who’ in the field of onychology,^[6] the journal surely looks forward to growing stronger with the upcoming issues.

Many advances in the fields of nail surgery, including injectable therapy techniques, the definition of nail unit incision lines^[7] (similar to relaxed skin tension lines),and nail biopsies of various types, have enabled us to enter an era where operating on the nail unit has become practically scar-less. Even though onychosurgery is an integral part of onychology, exploding research in this field has prompted us to include ‘nail surgery’ prominently in the title of JONS. Just like dermatologic disease, many nail diseases necessitate surgical intervention, and dermatologists are best placed at understanding the complex anatomy and physiology of the nail unit, which is pivotal to ensuring good surgical outcomes. Foremost example is the ingrown nail, which is such a common condition, but is still mismanaged in many cases. Nail biopsy techniques have moved from the more extensive longitudinal nail biopsies^[8,9] to less invasive procedures^[10,11] including nail plate biopsies^[12,13] or tangential matrix biopsies.^[14] Commensurate with this, the histopathologic criteria for nail diseases have also evolved through various studies.^{[8, 15-18]} This growth is in addition to the developments in non-invasive diagnostics in onychology.^[19,20] Nail surgical techniques have been refined and documented in devoted texts by Krull et al.^[21] and Richert et al.^[22] Injectable therapies in nails have been emerging with scientific evidence in their support through various devoted works.^[22-24] Aesthetic enhancement of nails is an ever-expanding field in itself, considering the importance people attach to the appearance of their nails.

The immense strides made in the field of onychology over the past few decades have been fuelled by the emergence of organised societies and professional organisations devoted to onychology. The Council for Nail Disorders, USA, was the first organised group of healthcare professionals formed to advance education for physicians and the general public regarding the diagnosis and management of nail disorders.^[25] The European Nail Society followed soon in 1997.^[26] The NSI was founded in the year 2012 to encourage and advance knowledge and practice regarding nails in health and disease.^[27] It has worked relentlessly toward promoting scientifically rational practice and research in nail disease, educating physicians about the latest advances through scientific programs, promoting interactions among specialists in India and abroad, and publishing in this field. The society took the initiative to publish the ‘Textbook of Onychology’ in 2021 to ensure formal training and education in this field.^[28] NSI has also been regularly organising its independent annual conference on nail diseases (ONYCHOCON) uninterrupted since 2012. The International Nails Society was formed in Greece in the year 2017 to coordinate, complement and empower the various National Societies. It organises the International Summit for Nail Diseases.

With this inaugural issue of JONS, we deliberate on various aspects of nails in health and disease, including morphological alterations as well as deeper systemic issues associated with it. Nail disorders are one of the common reasons for consultation with dermatologists, and NSI is committed to encourage evidence-based practice in this field. Through JONS, we hope that we will be able to enrich the literature and strengthen evidence in this field. The journal aims to publish quality reviews, original research, interesting case reports/case series, enlightening opinion pieces, interesting images and representative onychoterminology so that the readers can be made aware of the advances in this field. It is an open-access and peer-reviewed journal without any author publication charges.^[29] We would be happy to receive contributions from nail enthusiasts from across the world. The journal will be published bi-annually initially. It has a user-friendly online submission and review system. Detailed author instructions and other relevant information can be accessed through our website at https://nsijournal.com/.

I am thankful to NSI, especially the Executive Team, for taking this much-needed step and reposing faith in me to spearhead the nascent effort. I also thank all the members of the Editorial Board for their enthusiastic support, prompt response, and helpful attitude. They are the true stars who are lending their shine to the journal. Together, we wish to continue expanding the field of onychology with contributions from experts across the world. On behalf of the Editorial Board members, I request all of you nail enthusiasts to submit your valuable research to JONS.

Onychology has been making great strides over the past few decades, as the importance of the nail for an individual’s functioning as well as the psyche is being recognised. The deeper interlinking of nails with dermatological as well as systemic diseases has ignited renewed interest in it. The growth of onychology is hand-in-hand with the growth of associations working in this field. We hope this also reflects in the growth of JONS over the coming years! The important role of this journal will be to generate interest and create awareness among readers. We sincerely hope that JONS attracts more readers, learners, researchers, and contributors over the coming years!

Long live JONS! Long live NSI!