Dermatology Made Simple : Changes in Nails in Systemic Disease

Changes in Nails in Systemic Disease

The nails may undergo many changes in various systemic diseases.

These changes vary according to the type of the disease and they also constitute important clinical signs and help in diagnosis of the nature of diseases.

Some of the common changes that occur in nails in systemic diseases are discussed below:

Clubbing:

This refers to loss of the normal angle between the base of nail and nail bed.

Also there would be an increase in the longitudinal and transverse curvature of the nails.

It occurs due to long standing swelling of periungal tissues of the nails secondary to hyperdynamic circulation in that part.

It has assocaitions with a range of diseases affecting different systems of the body.

Some of these are as follows:

Respiratory System:

Lung fibrosis

Fibrosing Alveolitis

Lung carcinoma

Bronchiectasis

Lung abscess  

Idiopathic Pulmonary Fibrosis

Cardiovascular Diseases:

Infective Endocarditis

Cyanotic Heart Diseases

Gastro Intestinal Systems:

Heaptocellular Carcinoma

Cirrhosis of Liver

Inflammatory Bowel Diseases : Crohns”s Disease

Ulcerative Colitis

Autoimmune Chronic Hepatitis

Primary Biliary Cirrhosis

Primary Sclerosing Cholangitis

 Clubbing of Nails

Koilonychia:

Also called as Spoon shaped deformity of the nails.

This is usually seen in adults in iron deficiency Anemia.

In children it occurs as normal variant.

 Koilonychai of Nails