Common changes in nails are

  • Clubbing
  • Koilonychia
  • Onycholysis
  • Abnormal color like yellow, blue
  • Nail bed changes
  • Splinter hemorrhages
  • Lines or bands- Beaus, Mees lines

Clubbing

It is the increase in the angle between the nail and the nail bed.

Place the two index fingers of the patient against each other , look for the diamond shaped gap in between the nails. If no gap is visible, clubbing is present

Causes (Remember as mnemonic CLUBBING)

  • Cyanotic heart conditions
  • Lung conditions- hypoxia, Bronchiectasis, Cystic fibrosis
  • Ulcerative colitis, Crohns
  • Biliary cirrhosis
  • Infective endocarditis
  • Neoplasms
  • Gastrointestinal malabsorption

Koilonychia

It is spoon shaped nails

Causes

Iron deficiency

Onycholysis

It is the nail separation from nail bed

Cause

  • Tauma
  • Fungal infections
  • Raynaud’s syndrome

Pitting of nail

Causes

  • Psoriasis
  • Atopic eczema
  • Alopecia areata

Thickening of nails

Causes

  • Psoriasis
  • Fungal infection

Leukonychia

It is white spots on nails

Causes

  • Normal variant
  • Poisoning like arsenic, lead
  • Hypoalbuminemia

Splinter hemorrhage

Its the tiny hemorrhages in nail bed

Causes

  • Infective endocarditis
  • Psoriatic arthritis
  • Systemic lupus erythematosus

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