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July 8, 2013 at 3:13 PMComments: 0 Faves: 0

Fingernail Findings May Reveal More Significant Disease

By Jeffrey VanWingen M.D. More Blogs by This Author

They say that the eyes are the window to the soul. As an indicator to a person's demeanor, this may be true. However, doctors use many parts of the body to open windows revealing deeper diseases which may negatively impact health. While my last blog discussed healthy fingernails, this one will reveal how fingernail symptoms can open a window to various health problems.

Nail Pitting

Pits or dents in the nails may be a sign of psoriasis. Typical psoriasis is quite obvious with scaly, itchy patches on the skin. Sometimes, however, it can be difficult to distinguish this condition from eczema. Nail pits can raise suspicion that a skin condition is actually psoriasis and open the door to more effective treatment. But psoriasis doesn't necessarily always present with a rash. Sometimes, the illness reveals itself with joint pain (psoriatic arthritis), which has a similar discomfort level to osteoarthritis.

Again, pits can open the window to an unsuspected diagnosis and more effective treatment. In addition to psoriasis, pitting nails can be inconsistent findings in Reiter's Syndrome (arthritis and eye problems) and alopecia areata (patchy hair loss caused by the immune system).

Enlarged Fingernails

Enlargement of the finger tips and fingernails with nails curving around the finger tips is known as clubbing. Clubbing results from chronic low levels of oxygen supply to the tissues. This is often the result of disease from smoking. It may also be seen in congenital heart disease, tuberculosis, cystic fibrosis, and lung cancer. Rarely, clubbing can be seen in liver disease, inflammatory bowel disease (Crohn's Disease and ulcerative colitis), and AIDS.

Dark "Splinter-Like" Lines

Dark lines resembling splinters under the skin are called splinter hemorrhages. These are actually little blood clots that form in the blood vessels under the nail or are deposited from a distant source. Splinter hemorrhages can be seen as a herald of an insidious infection on the heart valves that break off little clots (emboli), which then travel to the finger tips. They can also be a sign of various autoimmune diseases (disorders where the immune system attacks the body). Examples include rheumatoid arthritis, scleroderma, lupus, or antiphospolipid syndrome. However, in most cases, splinter hemorrhages have no particular cause. But if seen, investigating further for possible causes is a good idea.

Separating Fingernails 

Finger nails that separate from the skin for no particular reason are relatively common. This condition is known as onycholysis ("on-ick-o-lie-sis"). Occasionally, a greenish hue is seen on the nail. Most of the time, onycholysis presents as a result of injury or for no identifiable reason at all. However, it can be associated with low thyroid levels, and blood testing is warranted to check the thyroid when this finding is observed.

Dark Rims at the Farthest Part of the Attached Nail

These dark arches are known as Terry's Lines. If present, all of the finger nails are involved. While most often related simply to aging, they can be a sign of uncontrolled diabetes, congestive heart failure, or liver disease.

"Scoop-Shaped" Nails

This condition is commonly known as spooning or, more formally, koilonychia ("coil-o-nick-ee-ah"). The condition is seen with extreme softening of the nails. This finding is often seen when the patient is lacking iron (iron deficiency anemia) or has a genetic disease where there is too much iron (hemochromatosis).

Ridges Across the Nails

Perpendicular ridges seen uniformly across the nails are known as Beau's Lines. This finding usually indicates that something has shocked the system, briefly interrupting growth. Examples of this include severe infection, high fever, periods of uncontrolled diabetes, or significant injury. In the absence of an explainable cause, however, it can indicate a deficiency of zinc.

In Conclusion

Fingernail abnormalities can open the window of discovery to various diseases affecting the body. If you have some unusual, unexplained issues with your finger nails, consider seeing your doctor, as this may explain some other seemingly unrelated problem.

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