Nail changes
Nail Plate
Abnormality
(spooning)
Nail Bed
Abnormality
Iron Deficiency
Anemia
Beau’s lines
Trachyonychia
(Linear Ridging)
Discoloration
Alopecia Areata
Oil Drop sign
Psoriasis
Brown/black
linear streak
Melanocytic
nevus
Malignant
melanoma
Drug-induced
discoloration
Legend:
Systemic disease
Primary dermatologic disease
Onychomycosis
Psoriasis
Hyperthyroidism
Fungi
Hyperkeratosis
Chronic hypoxia
Bronchiectasis
Lung cancer
Asbestos
Cystic fibrosis
Blue
Red
discoloration Discoloration
(thickening)
Onychomycosis
Onychogryphosis
If white/yellowbrown:
Onychomycosis
If green:
Pseudomonas
Bronchopulmonary dx
Systemic dx transiently
halting nail growth (i.e.
malnutrition, shock)
Psoriasis
Alopecia
Areata
Cardiovascular dx
Cyanotic
heart disease
Telangiectasia
SLE
Scleroderma
Dermatomyositis
(DM)
(horizontal grooves)
Pitting
Onycholysis
Nail Fold
Abnormality
Koilonychia
Clubbing
Gastrointestinal dx
IBD
GI cancer
Medications
Wilson’s disease
Silver poisoning
Cyanosis
Endocrine dx
Other
Hyperthyroidism
HIV
(grave’s disease) Congenital
defect
(dark red, thin
lines, painful)
Bacterial
endocarditis
Trauma
Terry’s Nails
Inflammation
Lateral
Only
(erythema,
swelling, pain)
Ingrown
nail
White
discoloration
Half & Half
Nails
(proximal 90%
white)
Chronic renal
Liver cirrhosis
failure
Congestive heart
Uremia
failure
Diabetes mellitus
Lateral and
Proximal
Acute
paronychia
Chronic
paronychia
Muehrcke’s
lines
(transverse lines)
Nephrotic
Syndrome
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