Guide to Clinical Examination/Quick Guide/Quick examination of everything

FINGERNAILS

The condition of the nail beds has been associated with no fewer than 24 diseases. Here are some signs to observe:

Curved down at the tip = associated with respiratory, heart or liver disease

Curved up = nutritional deficiency esp Iron (koilonychia)

Ridges

--transverse (Beau’s lines) = hyperthyroid, also infectious diseases such scarlet fever or typhus

--longitudinal = rheumatoid disease

White lines (Mee’s lines) = heart disease, Hx of fever, arsenic poisoning

Absence of lighter area at base = hypo-thyroidism or cardiac weakness

Enlarged area at base = hyper-thyroidism

Bluish area = Wilson’s disease

Reddish area = Cardiac failure, hypo-thyroid

Entirely white nail (Terry’s nails) = cirrhosis, hypo-albuminemia

Half & half (Lindsay’s nails) = renal disease

Hemorrhages in nail = subacute bacterial endocarditis, trichinosis

Pitted and discolored = Psoriasis

Crumbling = Onycholysis = fungal infection

Thickened = Onichogryposis = Thyroid toxicosis