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Dermatology > 16: Systemic Nail Manifestations - Mahoney > Flashcards

16: Systemic Nail Manifestations - Mahoney Flashcards

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Dermatology Board Prep flashcards
1
Q

black streak common in african americans

A

melanonychia

  • looks like melanoma: if diagnosis uncertain, remove nail and perform superficial shave biopsy of lesion. submit both shave and nail for pathology.
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2
Q

absence of nail

A

anonychia

  • could be due to alopecia areata and nail-patella syndrome
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3
Q

why do nails become more brittle with age?

A

normal aging loses H2O in the form of vapor and nail growth rate decreases

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4
Q

distal end of matrix is high compared with proximal end

A

clubbing

  • loss of the normal angle betwen nail and the posterior nail fold
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5
Q

positive schamroth’s test

A

clubbing

two index fingers are put nail to nail and there is loss of normal diamond-shaped recess

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6
Q

most common cause clubbing nails ****

A

bronchiogenic CA

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7
Q

white nail / terry’s nail indicates …

A

hepatic cirrhosis

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8
Q

paired, narrow white bands that run parallel with the lunula and are separated from one another and from the lunula by areas of normal pink nail

A

Muehrcke’s lines

  • due to hypoabluminemia
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9
Q

puntate or striped white bands associated with arsenic poisoning

A

Mee’s lines

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10
Q

white nail plate

A

leukonychia

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11
Q

what could a blue-green nail be?

A
  • pseudomonas
  • subungual hematoma
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12
Q

red half moons indicate …

A

congestive heart failure

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13
Q

blue half moons indicate …

A

hepato-lenticular degeneration (Wilson’s disease)

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14
Q

“half-and-half” nail with proximal nail bed white and distal half red, pink or brown indicates …

A

renal disease and azotemia

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15
Q

ABCDEF of subungual melanoma

A

African-american, native American, Asian

band is brown-black, breath is greater than 3 mm, border is irregular

Change is rapid in size or growth rate

Digit is most commonly the hallux

Extension into surrounding skin (Hutchinson’s sign)

Family or personal history of melanoma or dysplastic nevus syndrome

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16
Q

describe yellow nail syndrome

A

nails cease, or almost cease, to grow and some months later take on a yellow color

  • remain smooth but may be excessively curved
  • bronchiectasis, bronchitis, pleural effusion cause
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17
Q

subungual hemorrhage

A

bleeding of nail bed

18
Q

“spoon-shaped” nail

  • concave dorsally, distal end depressed below normal level due to anoxia and atrophy of distal connective tissue
A

koilonychia

* associated with iron deficiency anemia

19
Q

onycholysis

A

separation of nail from its bed

  • can be partial or total and due to many causes
20
Q

“parrot beaking” indicates …

A
  • scleroderma, normal, or TB
  • nails look like a beak curving around the atrophic soft tissue of the tips of the toe
21
Q

most common reason pitting nails

A

psoriasis

  • pits are due to retention of nuclei (parakeratosis) in parts of the nail keratin
  • these areas weaker than surrounding normal keratin and may be shed leaving pits on nail surface
22
Q

cuticle appears to grow forward on the nail plate and the nail is split into two portions

A

pterygium formation

  • results from fusion of epidermis of the dorsal nail fold to the nail bed and matrix
  • associated with lichen planus ***
23
Q

loosening of nail at base vs. separation from nail bed

A

onychomadesis

onycholysis

24
Q

splinter hemorrhages are classically associated with …

A

subacute bacterial endocarditis

  • longitudinal, thin black lines of hemorrhaging below the nails
25
Q

“inverted fir tree”

slightly off-centered split with feather y cracks extending laterally from the split

A

median nail dystrophy

26
Q

identify

A

habit tic

27
Q

single transverse depression

A

beau’s line

  • disability which temporarily interferes with the rate of growth of the nail (ex: chemo)
28
Q

describe psoriatic nail

A
  • most common disease associated with pitting
  • partial onycholysis starting at free edge
  • opaque, discolored, irregular, thickened, pustular
  • formation of hyperkeratosis at free edge
  • over curvature
  • arthropathy
29
Q

describe eczematic nail

A
  • most common is atopic or contact dermatitis which leads to atrophic changes
  • irregular ridges across nail
  • pitting
  • subungual hemorrhage
  • gross hypertrophy and onycholysis occur less frequently
30
Q

most common nail change with lichen planus

A

longitudinal ridging with slight depressions on surface and thinning and pterygium formation

31
Q

keratoderma blenorrhagicum lesions

A

reiter’s syndrome

  • cant see, cant pee, cant climb a tree
32
Q

nail changes associated with scleroderma

A

parrot beaking

  • changes primarily due to impaired peripheral circulation
33
Q

cuticle broken with hemorrhagic leisons in the area

A

SLE

34
Q

patches of erythema with telangectasia over the posterior nail folds

erythema over toe joints

A

dermatomyosistis

35
Q

describe the nails …

pemphigus/epidermolysis bullosa

sarcoidosis

scabies

A
  • shedding of nails with nail bed scarring
  • thickened, irregular with damage to distal phalanx
  • thickened and opaque
36
Q

nail changes due to chemo

A
  • beau’s lines
  • pigmentary changes
  • onychomadesis
  • transverse leukonychia
37
Q

these drugs cause …

zidovudine/retrovir

tetracycline and doxycycline

minocycline

lithium

chloroquine

accutane

A
  • longitudinal brown or blue-brown lines or diffuse coloration of entire nail
  • photosensitive onycholysis
  • blue-gray pigmentation of nail bed of longitudinal pigmented lines
  • transverse brown bands with leukonychia
  • blue/balck or blue/brown pigmentary changes
  • fibromas
38
Q

cardiovascular and hematologic disease

A
  • splinter hemorrhages
  • red lunula
39
Q

GI disease

A
  • terry’s nail
  • blue half moons
  • brown nails of hyperbilirubinemia
  • chronic hepatitis may cuase splinter hemorrhages, clubing and white nails
40
Q

renal disease

A
  • half and half nail / lindsay’s nail
  • anonychia
  • longitudinal ridging
  • koilonychia
  • muehrcke’s lines
  • increased in red color in renal adenocarcinoma due to increased erythropoeitin
41
Q

pulmonary disease

A
  • yellow nail syndrome
  • clubbing
42
Q

endocrine disease

A
  • longitudinal pigmented bands in addison’s disease
  • short, wide, thick, flat nails in acromegaly
  • proximal nail bed telangiectasia with yellow nails in diabetes
  • brittle nails with longitudinal sulci in hypothyroidism

Dermatology (24 decks)

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