Just to further the conversation regarding nail abnormalities...if anyone is wondering...or wishes to rule out hypochondria...
Quote from American Family Physician website...
Nail Abnormalities: Clues to Systemic Disease
Robert S. Fawcett, M.D., M.S., Thomas M. Hart Family Practice Residency Program, York Hospital, York, Pennsylvania
Sean Linford, M.D., and Daniel L. Stulberg, M.D., Utah Valley Family Practice Residency Program, Provo, Utah
Am Fam Physician. 2004 Mar 15;69(6):1417-1424.
The visual appearance of the fingernails and toenails may suggest an underlying systemic disease. Clubbing of the nails often suggests pulmonary disease or inflammatory bowel disease. Koilonychia, or “spoon-shaped” nails, may stimulate a work-up for hemochromatosis or anemia. In the absence of trauma or psoriasis, onycholysis should prompt a search for symptoms of hyperthyroidism. The finding of Beau’s lines may indicate previous severe illness, trauma, or exposure to cold temperatures in patients with Raynaud’s disease. In patients with Muehrcke’s lines, albumin levels should be checked, and a work-up done if the level is low. Splinter hemorrhage in patients with heart murmur and unexplained fever can herald endocarditis. Patients with telangiectasia, koilonychia, or pitting of the nails may have connective tissue disorders.
Careful examination of the fingernails and toenails can provide clues to underlying systemic diseases (Table 1). Clubbing, which is one example of a nail manifestation of systemic disease, was first described by Hippocrates in the fifth century B.C.1 Since that time, many more nail abnormalities have been found to be clues to underlying systemic disorders.
The nail plate is the hard keratin cover of the dorsal portion of the distal phalanx. The nail plate is generated by the nail matrix at the proximal portion of the nail bed (Figure 1). As the nail grows, the distal part of the matrix produces the deeper layers of the nail plate, while the proximal portion makes the superficial layers. This production is important, because a disruption of function in the proximal matrix (as may occur in patients with psoriasis) results in more superficial nail problems (e.g., pitting). A disruption of the distal matrix may cause problems with the deeper layers, resulting in ridging or splitting. A transient problem causing growth disturbance may lead to the formation of transverse lines across the nail plate, as in Mees’, Muehrcke’s, and Beau’s lines (Figure 2). Changes in the configuration of the capillaries in the proximal nail bed are responsible for some of the alterations that occur in patients with connective tissue disorders, while abnormalities in the periosteal vessels contribute to clubbing.2
TABLE 1
Nail Findings and Associated Systemic Conditions
Nail finding Associated systemic conditions
Shape or growth change
Clubbing
Inflammatory bowel disease, pulmonary malignancy, asbestosis, chronic bronchitis, COPD, cirrhosis, congenital heart disease, endocarditis, atrioventricular malformations, fistulas
Koilonychia
Iron deficiency anemia, hemochromatosis, Raynaud’s disease, SLE, trauma, nail-patella syndrome
Onycholysis
Psoriasis, infection, hyperthyroidism, sarcoidosis, trauma, amyloidosis, connective tissue disorders
Pitting
Psoriasis, Reiter’s syndrome, incontinentia pigmenti, alopecia areata
Beau’s lines
Any severe systemic illness that disrupts nail growth, Raynaud’s disease, pemphigus, trauma
Yellow nail
Lymphedema, pleural effusion, immunodeficiency, bronchiectasis, sinusitis, rheumatoid arthritis, nephrotic syndrome, thyroiditis, tuberculosis, Raynaud’s disease
Color change
Terry’s (white) nails
Hepatic failure, cirrhosis, diabetes mellitus, CHF, hyperthyroidism, malnutrition
Azure lunula
Hepatolenticular degeneration (Wilson’s disease), silver poisoning, quinacrine therapy
Half-and-half nails
Specific for renal failure
Muehrcke’s lines
Specific for hypoalbuminemia
Mees’ lines
Arsenic poisoning, Hodgkin’s disease, CHF, leprosy, malaria, chemotherapy, carbon monoxide poisoning, other systemic insults
Dark longitudinal streaks
Melanoma, benign nevus, chemical staining, normal variant in darkly pigmented people
Longitudinal striations
Alopecia areata, vitiligo, atopic dermatitis, psoriasis
Splinter hemorrhage
Subacute bacterial endocarditis, SLE, rheumatoid arthritis, antiphospholipid syndrome, peptic ulcer disease, malignancies, oral contraceptive use, pregnancy, psoriasis, trauma
Telangiectasia
Rheumatoid arthritis, SLE, dermatomyositis, scleroderma
COPD = chronic obstructive pulmonary disease; SLE = systemic lupus erythematosus; CHF = congestive heart failure.
End quote...
Take care...cheers