Change in the Nails – What it Could Mean

This is a “change in the the nails” cheat sheet of what our professionals can see on a daily basis.  Be aware and inform your client if you notice any change in the nails.

Potential Problems
  • WHITE NAIL SYNDROME:  The whole nail will appear cloudy or white.  This change in naill health could indicate heart disease, renal failure, liver cirrhosis, pulmonary tuberculosis, diabetes or rheumatoid arthritis.
  • TERRY’S NAIL:  The nail will look white & grainy with a pink or red strip at the top.  This change is found in 80% of people with liver cirrhosis, as well as those with congestive heart failure, hyperthyroidism, malnutrition, diabetes or HIV.
  • MUEHRCKE’S NAILS:  Abnormal blood flow in the nail bed will make the nails appear as if they have horizontal white lines.  Most often in the 2nd, 3rd & 4th fingers.  Press the nails to make disappear.  This forces blood out of the nail bed blood vessels.  Health conditions associated with this is hypoalbuminemia, liver disease, malnutrition & nephrotic syndrome.  It is also a side effect of chemotherapy.
  • LINDSAY’S NAILS:  The bottom half of the nail appears white while the top half is a darker pink-brown.  This is typical when there is swelling in the nail bed at the bottom. In addition to increased melanin production at the top.  Chronic renal disease of HIV could be the cause of this condition.
  • MEE’S LINE:  Horizontal white lines appear in the nail.  Disrupted nail growth causing microscopic fragmentation. Mee’s lines could indicate heart failure, Hodgkin disease, renal failure, infection or poisoining by arsenic, thallium or other heavy metals.
More Potential Problems
  • SPLINTER HEMORRHAGES:  Thin, dark red or brown vertical lines in the nail bed. They look like splinters beneath the nails.  Possible causes include cirrhosis, mitral stenosis, oral contraceptive use, pregnancy, peptic ulcer disease, scleroderma, rheumatoid arthritis, systemic lupus erythematosus, vasculitis & trauma.
  • YELLOW NAIL SYNDROME:  A rare condition.  Nails appear yellowish-orange & thicken & curve into the cuticle.  It is associated with impaired lymphatic drainage, pleural effusions & bronchiectasis.
  • BLUE NAILS:  Not always the whole nail, could just be the lunula.  This could indicate Wilson’s disease, silver poisoning or caused by therapy used to treat lupus & other health conditions.
  • RED LUNULA:  Lunulas that appear red could indicate alopecia (hair loss), carbon monoxide poisoning, cardiac failure, chronic obstructive pulmonary disease, hives, cirrhosis, oral prednisone treatment or psoriasis.
  • VERTICAL BROWN STREAKS:  Common among those with dark skin.  However, it could indicate melanoma & should be checked immediately.  A benign nevus or chemical staining could also be the cause (hair color & nail polish)

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