Which condition is not typically associated with changes in nail appearance?

The choice of cosmetic nail polish as the condition not typically associated with changes in nail appearance is accurate because cosmetic nail polish is applied externally and does not affect the underlying nail structure or health. Nail polish is designed to provide a temporary change in appearance, such as adding color or shine, without causing intrinsic changes to the nail itself.

In contrast, fungal infections, systemic illnesses, and nail trauma can lead to significant alterations in the nail's physical characteristics. Fungal infections often result in discoloration, thickening, and potential crumbling of the nail. Systemic illnesses, such as liver disease or thyroid disorders, can cause various changes in nail texture and appearance, including ridges, indentations, or changes in color. Nail trauma can lead to outcomes like bruising under the nail, distortion of nail growth, or even nail loss. Thus, cosmetic nail polish remains solely a superficial treatment without any impact on the health or structure of the nails.