Nails Flashcards
Several nails with thinning and fissuring, and with dorsal pterygium
lichen planus
(dorsal pterygium = scarring of the proximal nail fold over the nail plate)
White discoloration that fades with pressure; often due to chemo or systemic disease
apparent leukonychia
What causes Green Nail Syndrome (a greenish-black or greenish-blue nail plate discoloration)
Pyocyanin, a blue–green pigment produced by Pseudomonas aeruginosa
White, opaque discoloration due to damage of the distal matrix; no changes with pressure.
true leukonychia
Transverse nail plate depression, resulting from (traumatic) disruption of the nail plate formation by the nail matrix.
Beau’s lines
Affected area often connected to DIP joint and may drain joint fluid
Myxoid cysts (Digital Mucous Cyst)
Associated with cardiopulmonary disease, sarcoidosis, cirrhosis, gastrointestinal disease, toxin exposures, trauma
clubbing
Pitting is due to foci of abnormal keratinization in the (proximal/distal) nail matrix.
proximal
Rough, rigid surface and proximal nail matrix damage associated with alopecia areata, lichen planus, psoriasis, eczema.
trachyonychia
White proximally and brown-red distally; associated with chronic renal disease
Lindsay’s nails
Nail fold capillary abnormalities and cuticular hemorrhages
A/I CT Disorders
common in dermatomyositis and scleroderma
Fungal infection associated with immunocompromise (HIV)
Proximal subungual onychomycosis, most commonly from Trichophyton rubrum
Transverse white bands usually associated with arsenic and thallium toxicity. Unchanged with pressure
Mees’ lines
Over-curvature of the distal nail plate; can be hereditary or acquired
Pincer Nails
Acute trauma > accumulation of blood under the nail plate; pigmentation moves distally with nail growth
Subungual Hematoma
Multiple longitudinal brown-black bands
Longitudinal Melanonychia, often due to drugs or systemic disease
Pink or skin-colored papules originating from the proximal nail fold; fibroma may compress the nail matrix, which produces a longitudinal groove in the nail plate
Periungual Fibromas
Benign bony proliferation causes subungual, hard nodule; often due to trauma and confirmed with XR
Subungual Exostosis
Proximal nail fold inflammation associated with absence of the cuticle; fingernails affected
Chronic Paronychia
*chronic irritation vs Candida
distal superficial splitting (horizontally) of the nail plate
Onychoschizia
Nail plate destruction and longitudinal melanonychia, most frequently in thumb
melanoma
Foci of abn keratinization in the proximal nail matrix; characteristic of psoriasis, alopecia, areata, eczema.
pitting
Irregulat pitting, Beau’s lines, subungal hyperkeratosis, chronic paronychia
Eczema
Cuticle absent and proximal nail fold inflamed
Nail plate surface abnormalities (e.g. longitudinal central depression)
Melanonychia, hemorrhage and crust
Onychotillomania
Distal nail plate detachment from the nail bed; often due to psoriasis or fungal inf.
onycholysis
ingrown nails
Onychocryptosis
Periungual keratotic papules, hyperkeratosis of the cuticle and onycholysis
Warts, from HPV
Geometric pitting and trachyonychia (rough/ridges)
Often in children
Alopecia Areata
Verrucous lesion, ulcerated nodule, onycholysis, and nail plate destruction
Often due to HPV
Squamous Cell Carcinoma
White proximally with 1-few mm of brown-red distally; associated with cirrhosis
terry’s nails
“Spoon nails”; hereditary or caused by iron deficiency anemia.
koilonychia
Multiple nails with pitting, Salmon patches, and nycholysis with erythematous border
psoriasis
Apparent leukonychia with transverse white bands, associated with hypoalbuminism
Muehrcke’s lines
Proximal matrix forms the ____ nail plate. Distal matrix forms the _____ nail plate.
dorsal ventral (disTal>venTral)
Often traumatic bleeding angiomatous nodule (periungual or subungual)
Pyogenic Granuloma
Ram’s horn nails, likely due to trauma and likely in elderly pts
Onychogryphosis
Acute swollen, red and painful digit; compression of the nail fold may produce purulent drainage.
Acute Paronychia, commonly due to Staphylococcus aureus or Streptococcus pyogenes
Extravasated blood visible beneath nail plate caused by damage to longitudunally oriented nail bed capillaries.
Associated with bacterial endocarditis
splinter hemorrhage
Single longitudinal brown-black band
Longitudinal Melanonychia, possibly due to nail melanoma
