Systemic Nail Infections

Question 1

what is melanonychia and is it a normal or abnormal finding?

Answer 1

(black streak) in the nail that is a NORMAL finding; especially common in African-Americans

Question 2

is longitudinal ridging a normal or abnormal finding?

Answer 2

normal finding that occurs with aging

Question 3

what is anonychia? what disorders is it seen with?

Answer 3

(absence of nail)

-seen with alopecia areata and nail-patella syndrome

Question 4

what is clubbing of the nails indicative of?

Answer 4

lung disease (bronchiogenic CA)

Question 5

what is chromonychia?

Answer 5

color changes in the nail

Question 6

what is white nail (Terry’s nail) associated with?

Answer 6

hepatic disease

Question 7

what is Muehrcke’s lines associated with?

Answer 7

hypoalbuminemia

Question 8

what is Muerhcke’s lines?

Answer 8

paired, narrow white bands that run parallel with the lunula

Question 9

what is Mee’s lines associated with?

Answer 9

arsenic poisoning

Question 10

what is Mee’s lines?

Answer 10

striped white bands associated with arsenic poisoning

Question 11

how do you differentiate btwn Muerhcke’s lines and Mee’s lines?

Answer 11

Mee’s lines tend to be more than 2 lines and is not continuous across the transverse nail plate

Question 12

what is leukonychia?

Answer 12

white nail

partial leukonychia is very common

Question 13

blue-green nail indicates what?

Answer 13

pseudomonas infection

subungual hematoma

Question 14

red half-moon indicates what disease?

Answer 14

CHF

Question 15

blue half-moon indicates what disease?

Answer 15

hepato-lenticular degeneration (Wilson’s disease)

Question 16

half and half nail (aka Lindsey’s nail) indicates what disease?

Answer 16

renal disease and azotemia

Question 17

Differentials for a black streak in the nail?

Answer 17

• melanonychia (common finding in AA)
• melanoma
• subungual hematoma

Question 18

what is koilonychia? what disease is it associated with?

Answer 18

“spoon-shaped” nail seen with iron-deficiency anemia

Question 19

what is onycholysis?

Answer 19

separation of nail from its bed

Question 20

what is “parrot beaking” and what is it associated with?

Answer 20

nails look like a beak curving around the atrophic soft tissue of the tips of teh toe
-seen in scleroderma, or TB

Question 21

nail pitting is classically seen with what disease?

Answer 21

psoriasis

Question 22

pterygium formation is seen with what disease?

Answer 22

lichen planus

Question 23

what is pterygium formation in the nail look like?

Answer 23

overgrowth of cuticle onto nail plate and the nail is split into two portions

Question 24

splinter hemorrhages are assoicated with what?

Answer 24

subacute bacterial endocarditis

Question 25

what are Beau’s lines?

Answer 25

single transverse striation that is a depression in the nail seen commonly in patients under going chemotherapy

Question 26

what is a common nail finding seen in patients with psoriasis?

Answer 26

nail pitting

Question 27

what nail findings are commonly seen in patients with lichen planus?

Answer 27

pterygium formation

longitudinal ridging

Question 28

what nail changes are seen in scleroderma?

Answer 28

parrot beaking