Nail as a diagnostic tool PART 2

Splinter hemorrhage under the nail may result from trauma,psoriasis,rheumatoid arthritis other collagen vascular diseases and bacterial endocarditis. Bacterial endocarditis is the most common systemic disease associated with splinter hemorrhages. These hemorrhages are more common in subacute variety rather than acute variety.Although splinter hemorrhages in subacute bacterial endocarditis have been described as proximally located,no suitable evidence available to confirm this

Leukonychia. These marks are common, nonuniform, white lines found in differing spots on one or more nails. It should not be confused with Mees line(due to arsenic poisoning)and Muehrcke's line which are parallel to the lanula across the entire nail bed and occur in more than one nail.

Beau's lines. This condition presents as a transverse depressions in the nail that result from trauma, exposure to cold, Raynaud's disease, or any episodic disease condition serious enough to disrupt the normal nail growth

Raynauds phenomenon can lead to thinning and longitudinal ridging of nail plate

Muehrcke's line demonstrates as a transverse white bands parallel to the lanula. These bands usually occur in pairs and extend all the way across the nail.

Half and half nail with a white proximal and red or brown distal half is occasionally seen in patient with chronic renal failure

Whitening of nail plates may be related to hypoalbuminaemia as in cirrhosis of the liver

Nail fold erythema is a useful physical sign in dermatomyositis, systemic sclerosis and SLE


References :

Huchisons clinical method

Davidson’s Principles and practice of medicine

Nail disorder index

PART 1