Nail Findings and Associated Systemic Conditions
Nail Finding | Associated Systemic Condition |
---|---|
Shape or Growth Change | |
Beau's lines | Any severe systemic illness that disrupts nail growth, pemphigus, Raynaud's disease, trauma |
Clubbing | Asbestosis, atrioventricular malformations, chronic bronchitis, cirrhosis, congenital heart disease, COPD, endocarditis, fistulas, inflammatory bowel disease, pulmonary malignancy |
Koilonychia | Hemochromatosis, iron deficiency anemia, nail-patella syndrome, Raynaud's disease, SLE, trauma |
Onycholysis | Amyloidosis, connective tissue disorders, hyperthyroidism, infection, psoriasis, sarcoidosis, trauma |
Pitting | Alopecia areata, incontinentia pigmenti, psoriasis, Reiter's syndrome |
Yellow nail | Bronchiectasis, immunodeficiency, lymphedema, nephrotic syndrome, pleural effusion, Raynaud's disease, rheumatoid arthritis, sinusitis, thyroiditis, tuberculosis |
Color Change | |
Azure lunula | Hepatolenticular degeneration (Wilson's disease), quinacrine therapy, silver poisoning |
Dark longitudinal streaks | Benign nevus, chemical staining, melanoma, normal variant in darkly pigmented people |
Half-and-half nails | Specific for renal failure |
Longitudinal striations | Alopecia areata, atopic dermatitis, vitiligo, psoriasis |
Mees' lines | Arsenic poisoning, carbon monoxide poisoning, chemotherapy, CHF Hodgkin's disease, leprosy, malaria, other systemic insults |
Muehrcke's lines | Specific for hypoalbuminemia |
Splinter hemorrhage | Antiphospholipid syndrome, malignancies, oral contraceptive use, pregnancy, psoriasis, rheumatoid arthritis, SLE, subacute bacterial endocarditis, trauma |
Telangiectasia | Dermatomyositis, rheumatoid arthritis, scleroderma, SLE |
Terry's (white) nails | Cirrhosis, CHF diabetes mellitus, hepatic failure, hyperthyroidism, malnutrition |