Here is an extensive list of conditions affecting nails. I
think this will be very useful for quick summary of 'examination of nails' in medicine.
Changes in size and/or shape:
Racket nails:
- Congenital anomaly of thumbs in which the distal phalanx
is shorter & wider than normal.
- Also seen in Tertiary hyperparathyroidism.
Congenital abnormalities:
- Anonychia (complete absence)
- Micro- or Macronychia
- Onychoheterotopia(abnormally situated nail)
- Racket nail
- Leuconychia totalis (completely white nail)
Beau's lines:
- Transverse ridges on nails
- Develop during attacks of severe illness
- Also in Raynaud's syndrome & carpal tunnel syndrome
Longitudinal ridges:
- Elderly
- Rheumatoid arthritis
- Alopecia areata
- Lichen planus
- Psoriasis
- Darier's disease (keratosis follicularis)
Trachyonychia:
- Means roughness of nails
- Seen in alopecia areata, lichen planus & psoriasis
Pachyonychia:
- Thickening of nail plate
- Seen most commonly in onychomycosis(tinea unguium)
- Also congenital
- Hyperparathyroidism
- Vitamin D therapy
Onychorrhexis:
- Nail separates at lunula & is shed partially or
completely
- Seen in psoriasis
- Old age
- Systemic illness
- Eczema
- Paronychia
Onychomadesis:
- Complete shedding of nail
- Occurs in severe illness which results in sudden stopping
of nail growth
- Also in lichen planus
Onycholysis:
- Detachment of nail from its nail- bed (differs from
onychomadesis in that it begins distally or laterally)
- Hyperparathyroidism
- Psoriasis
Koilonyhchia:
- Spoon shaped nails
- Commonest in Iron deficiency anaemia
- Also in thyrotoxicosis
- Rheumatic fever
- Liver disease
- Occupationally in rickshaw pullers & oil workers
Clubbing:
- Respiratory causes: bronchogenic carcinoma,
bronchiectasis, lung abscess, empyema, fibrosing alveolitis, asbestosis, pleural
mesothelioma, cystic fibrosis.
- Cardiovascular causes: congenital cyanotic heart disease,
infective endocarditis, atrial myxoma..
- Gastrointestinal causes: ulcerative colitis, Crohn's
disease, primary biliary cirrhosis, sclerosing cholangitis, malabsorption
syndrome.
- Endocrine cause: Grave's disease
- CNS cause: ataxia telengiectasia
- Familial in Taurine- Gole- Solente syndrome
- Idiopathic
- Unilateral clubbing: aneurysm of subclavian or brachial
artery, Pancoast tumour, i.v. drug users.
- Unidigital clubbing: tophaceous gout, local trauma,
sarcoidosis.
Changes in colour:
White nails:
- Patchy white discolouration of nail plates is seen after
systemic illness such as MI, ulcerative colitis, etc.
- Mee's lines- transverse white bands are seen in arsenic
poisoning, Hodgkin's disease, palmar keratosis.
Yellow nails:
- Yellow nail syndrome associated with lymphatic hypoplasia
& lymphoedema, bronchiectasis & pleural effusion.
- Also after prolonged tetracycline therapy
Green nails:
- Seen in association with infection with pseudomonas spp.
Blue nails:
- chloroquine or mepacrine therapy
- Blue lunules in Wilson's disease
Red half moons:
- In congestive heart failure
Splinter haemorrhages:
- Infective endocarditis
- Rheumatic fever
- Disseminated malignancy
- Infectious mononucleosis
- Cryoglobulinaemia
Longitudinal brownish streaks:
- Addison's disease
- Subungual haematoma
- Melanocytic naevus
- Side effect of minocycline, zidovudine
- Lichen planus
- Laugier- Hunziker syndrome
Others:
Egg- shell nails:
- In avitaminosis A
Quincke's sign:
- Increased capillary pulsations
- Seen in aortic regurgitation & other conditions with
hyperdynamic circulation
Brittle nails:
- Chronic peripheral circulation impairment
- Iron deficiency anemia
Note: We would like to thank parin for compiling such a remarkable list of mail pathology. If you find this list useful, please help the RxPG community by submitting similar lists. The submission page is located at http://www.rxpgonline.com/submit.html
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