Our body is the most amazing creation. All of its systems showcase rare features. Before any disease body always shows some signs in different parts of the body, such as headache, fever, vomiting, and pain. Among all these, one part is always the first to manifest a serious bodily condition, which is the nails.
Careful observation of nail changes can help detect systemic diseases early, making it an essential part of physical examination in clinical practice.
- Clubbing of nails: normal nail angle is lost, and the nail becomes bulbous due to —
associated with chronic lung diseases and congenital heart conditions. - Cyanosis: bluish discoloration of the nail bed indicating a lack of proper oxygen supply, often seen in cardiac and respiratory disorders
- Pallor: Yellowish-pale discoloration of the nail bed indicating Anaemia
- Koilonychia, also known as a spoon-shaped nail, is associated with iron deficiency.
- Splinter hemorrhages: thin red-brown lines or streaks present on the nail bed indicate infective endocarditis or trauma
- Beau’s lines: these are transverse or horizontal grooves seen across the nail bed. The depth of the groove depends on the severity of the disease. Act as a timeline marker of past illness. Distance from the nail root helps estimate when the illness occurred.
(Nails grow ~1 mm per 10 days) Associated with malnutrition, severe infection, chemotherapy, major surgery, and trauma. - Terry’s nails: most of the nail bed appears white/ pale, but the tip of the nail has pink or brown discoloration. Commonly associated with Chronic liver disease, Liver cirrhosis.
- Half-and-half nails: also known as Lindsay’s nail. A well-defined division of the nail into two half appear. Where the proximal part appears pale, and the distal part appears reddish brown. Indicating CKD, uremia, and liver disease
Conclusion: Nails are an important part of clinical practice. As healthcare providers, we should make sure to assess the nails in our routine physical examination.
Have you ever come across these signs and symptoms?
MBH/AB