Nail Anatomy and Pathology Flashcards

Terry's nails are characterized by:

Answer: Brown distal band with white proximal nail plate, associated with cirrhosis, heart failure, or diabetes

Terry's nails show a predominantly white nail plate with a narrow pink-brown distal band and are associated with systemic conditions including hepatic cirrhosis, congestive heart failure, and diabetes.

Which nail pathology is most commonly caused by repeated microtrauma to the nail matrix?

Answer: Habit-tic deformity (central nail dystrophy)

Habit-tic deformity results from repetitive rubbing or picking of the proximal nail fold, disrupting matrix cell production and creating characteristic parallel transverse ridges.

A patient presents with a yellow, thickened, slow-growing nail with increased curvature and absent lunula. This describes:

Answer: Yellow nail syndrome

Yellow nail syndrome presents with the triad of yellow/green discoloration, slow growth, and lymphedema; it is associated with respiratory disorders and immunodeficiency.

The proximal nail fold is important clinically because:

Answer: Capillary changes in the nail fold can indicate connective tissue disease (e.g., scleroderma, lupus)

Nailfold capillaroscopy can reveal abnormal capillary patterns (dilation, dropout) that are diagnostic markers for connective tissue diseases such as dermatomyositis and systemic sclerosis.

Onychoschizia refers to:

Answer: Lamellar splitting and peeling of the distal nail plate

Onychoschizia is horizontal splitting or layering of the distal nail plate, commonly caused by repeated wetting and drying cycles, trauma, or nutritional deficiencies.

Which systemic condition is most strongly associated with clubbing (expanded, curved nail with increased angle)?

Answer: Chronic hypoxia from pulmonary or cardiac disease

Nail clubbing (Schamroth's sign positive) is strongly associated with chronic hypoxemia from conditions such as COPD, bronchiectasis, and cyanotic congenital heart disease.