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Nails- a window to internal organs: a cross sectional study of nail changes in systemic diseases in a tertiary care hospital
- Author Details:
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Dhanalakshmi Kathirvel
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Baskaran R
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Vaishanavi Dhandapani
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Gladius Jennifer H
Background: Many systemic disorders leave their mark on the nails and, therefore, provide physicians with valuable clues to diagnosis. In spite of this knowledge, there has been relatively little attention paid to the nails. This study will enlighten the importance of the nail changes associated with systemic diseases.
Objectives of the study:
· To evaluate the prevalence of the nail changes in systemic diseases.
· To assess the specificity of the nail changes with the disease status.
· To correlate nail changes with prognosis.
Materials and Methods: One hundred and fifty patients attending the outpatient and inpatients from the hospital were included. With informed consent, detailed history and clinical examination done including general physical examination and cutaneous examination. Nails were examined for their appearance, colour, contour, lunula, nail folds. Investigations were done according to the system involvement.
Results: Nail changes were common with inpatients (58.7%) compared to out-patients (41.3%) and in 5.4% patients it was incidental. Most commonly involved systems include respiratory system (23.4%) followed by haematopoietic (18%), GIT and liver (14%), renal (12%) and cardiovascular system (10%). Clubbing was the commonest nail change encountered (34.67%) followed by longitudinal ridging (29.33%), pallor of nail plate (28%), platyonychia (18.67%) and brittle nails (17.33%).
Conclusions: Clubbing in cardio respiratory system, half and half nail (HHN) in renal system and terry’s nail in liver and GIT are the specific nail changes that can lead us to the diagnosis. Prognosis is not directly related to the nail changes, commonly to the severity of the underlying disorders.
Keywords: Nail changes, Clubbing, Platyonychia
References
- Fleckman P. Anatomy and Physiology of the nail. Dermatol clin 1984;3:373-381.
- Daniel CR, Sams WM, Scher RK. Nails in systemic disease. In: Nails: Therapy, Diagnosis, and Surgery. 2 nd ed. Amsterdam: Elsevier Health Sciences;1997:219-50.
- Dupond AS, Magy N, Humbert P, Dupond JL. Nail manifestation of systemic diseases. Rev Prat 2000 Dec15;50(20):2236-40.
- Abraham S, Kamath N.P. Nail changes in systemic diseases: A clinical study of 435 cases. Indian J Dermatol Venereol Leprol 1998;64:144-145.
- Beni Amatya, Sudha Agarwal, Tapan Dhali, Sanjib Sharma, Shyam Sunder: Pattern of skin and nail changes in chronic renal failure in Nepal: A hospital-based study. Eur Acad Dermatol Nov 2007;21:340-344.
- Udayakumar P et al. cutaneous manifestations in patients with chronic renal failure on hemodialysis. Indian J Dermatol Venereol Leprol 2006;72(2):119-25.
- Dyachenko P, Monselle A, Shustak A, et al. Nail disorders in patients with chronic renal failure and undergoing hemodialysis treatment: a case control study. J Eur Acad Dermatol Venereol 2007;21:340-344. Dhanalakshmi Kathirvel et al. Nails- a window to internal organs Indian Journal of Clinical and Experimental Dermatology, January-March 2017;3(1):3-8 8
- Paucer, Karen et al. Cutaneous manifestations of patients who are in intermittent chronic hemodialysis in 3 centres of metropolitan Lima. Folia dermatol peru 2011;22(3):141-146.
- Nakatsui T, Lin AN. Onycholysis and thyroid disease: Report of 3 cases. J Cutan Med Surg 1998;3:40-42.
- Conn RD, Smith RH. Malnutrition, myxoedema, and Muehrcke's lines. Arch Intern Med Dec 1965;116(6):875-
How to Cite This Article
Vancouver
Kathirvel D, R B, Dhandapani V, H GJ. Nails- a window to internal organs: a cross sectional study of nail changes in systemic diseases in a tertiary care hospital [Internet]. IP Indian J Clin Exp Dermatol. 2017 [cited 2025 Oct 06];3(1):3-8. Available from: https://doi.org/
APA
Kathirvel, D., R, B., Dhandapani, V., H, G. J. (2017). Nails- a window to internal organs: a cross sectional study of nail changes in systemic diseases in a tertiary care hospital. IP Indian J Clin Exp Dermatol, 3(1), 3-8. https://doi.org/
MLA
Kathirvel, Dhanalakshmi, R, Baskaran, Dhandapani, Vaishanavi, H, Gladius Jennifer. "Nails- a window to internal organs: a cross sectional study of nail changes in systemic diseases in a tertiary care hospital." IP Indian J Clin Exp Dermatol, vol. 3, no. 1, 2017, pp. 3-8. https://doi.org/
Chicago
Kathirvel, D., R, B., Dhandapani, V., H, G. J.. "Nails- a window to internal organs: a cross sectional study of nail changes in systemic diseases in a tertiary care hospital." IP Indian J Clin Exp Dermatol 3, no. 1 (2017): 3-8. https://doi.org/