Palmar Erythema

Chronic Liver Disease

Pregnancy

Nitric Oxide

Pseudohypoparathyroidism

~Congenital end-organ unresponsiveness to PTH~

Arachnodactyly (spider fingers)

Marfan's syndrome

-(Positive) Thumb Sign

Arachnodactyly

Marfan's Syndrome

-(Positive) Wrist Sign

Arachnodactyly

Marfan's Syndrome

Beau's Line

(Severe, Palpable Mee's Nail)

Serious Illnesses

(Sepsis, Acute Renal Failure, Sickle Cell Crisis, MI, shock)

~multiple nails, single transverse band~

*Initially discovered related to Arsenic poisoning*

Muehrcke's lines

Hypoalbuminemia

~low albumin levels~

Lindsay Nail

Renal Failure (Kidney)

Terry's Nail

Chronic Hepatic Cirrhosis

(Liver)

Onychorrhexis

Old Nails

~Radiation damage, longitudinal ridging~

Onycholysis

Hyperthyroidism, Fungal Infections,

Phototoxis Drug Reactions

~Distal nail separates from bed~

Yellow Nail Syndrome

Exudative Pleural Effusion (Lung Carcinoma)

Lymphatic Obstruction

Onychomycosis

Fungus

~Yellowish/white, thickening~

Paronychia (Ingrown Nails)

Bacterial Infection

~Nail grows into dermis and gets infected~

Splinter hemorrhages

Infectious endocarditis, trichinosis

Manual Laborers

~red dots/lines in nail bed~

Paronychia

Bacterial Infection

(Acute or Chronic)

~redness, swelling, tenderness~

Subungual Hematoma

(not melanoma)

Trauma

~Pain relief from drainage is significant~

Subungual Melanoma

Cancer

~Usually not total discoloration under the nail~

Clubbing

Hypoxia

Cyanotic Congenital Heart Disease

Lung/Pleura Cancer

Lung Abscess

Bronchiectasis

Non-Hypoxia

Ulcerative Colitis

Hyperthyroidism

Cirrhosis

~proximal nail bed has spongy quality~

Nail Pitting

Psoriasis

Focal Trauma

Spoon Nails (Koilonychia)

Hypochronic Anemia

~iron deficiency~