Abstract
Nails disorders, in addition to being a disease sui generis (e.g., onychomycosis), can also be a marker for an internal disorder. For example, clubbing may be a manifestation of an internal cardiopulmonary disease, including malignancy. Other entities that are covered include traumatic nail changes and normal variations in nail appearance.
Keywords: clubbing, hematoma, hemorrhage, Koenen, melanonychia, nails, paronychia, tic habit.
A
Nail Findings and Associations
Transverse, parallel, paired white bands, known as Muehrcke’s lines and caused by hypoalbuminemia from nephrotic syndrome in this case, that result in localized edema of the nail bed.
Painful acute paronychia that developed over 24 hours with erythema, edema, and accumulation of purulent material at the cuticle and lateral nail fold.
Successful drainage of an acute paronychia following the insertion of a scalpel under the proximal nail fold just above the nail.
B
Clubbing
Typical bulbous shape of tips of fingers with hyperplasia of the vascular tissue at the nail base, causing a rocking sensation of the nail when the area is pressed. Note also the increased curvature of the distal nail of the thumb that is seen in profile (William Weston Collection).
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