Nail Disorders

Question 1

Clubbing Definition/Etiology

Answer 1

Proximal nail plate has greater than 180° angle

to nail fold, watch-glass nails, bulbous digits

Question 2

Clubbing

Associated Disease

Answer 2

Cyanotic heart disease, bacterial endocarditis,

pulmonary disorders, GI disorders, etc

Question 3

Koilonychia

Definition/Etiology

Answer 3

Spoon shaped nails

Question 4

Koilonychia

Associated Disease

Answer 4

Fe deficiency, malnutrition, DM

Question 5

Onycholysis

Definition/Etiology

Answer 5

Separation of nail plate from nail beb

Question 6

Onycholysis

Associated Disease

Answer 6

Psoriasis, dermatophytes, thyroid disease

Question 7

Onychogryphosis

Definition/Etiology

Answer 7

Hypertrophy of the nail plate producing a

curved, claw-like deformity

Question 8

Onychogryphosis

Associated Disease

Answer 8

Poor circulation, chronic inflammation, tinea

Question 9

Onychohemia

Definition/Etiology

Answer 9

Subungual hematoma

Question 10

Onychohemia

Associated Disease

Answer 10

Trauma to nail bed

Question 11

Onychomycosis

Definition/Etiology

Answer 11

Fungal infection of nail (e.g. dermatophyte,

yeast, mould)

Question 12

Onychomycosis

Associated Disease

Answer 12

HIV, DM, peripheral arterial disease

Question 13

Onychocryptosis

Definition/Etiology

Answer 13

Ingrown toenail often hallux with congenital
malalignment, painful inflammation,
granulation tissue

Question 14

Onychocryptosis

Associated Disease

Answer 14

Tight fitting shoes, excessive nail clipping

Question 15

V-Shaped Nicking

Definition/Etiology

Answer 15

Distal margin has v-shaped loss of the nail

plate

Question 16

V-Shaped Nicking

Associated Disease

Answer 16

Darier’s disease (keratosis follicularis)

Question 17

Pterygium Inversus Unguium

Definition/Etiology

Answer 17

Distal nail plate does not separate from

underlying nail bed

Question 18

Pterygium Inversus Unguium

Associated Disease

Answer 18

Scleroderma

Question 19

Pitting

Definition/Etiology

Answer 19

Punctate depressions that migrate distally

with growth

Question 20

Pitting

Associated Disease

Answer 20

Psoriasis (random pattern), alopecia areata

(geometric, grid-shaped arrangement), eczema

Question 21

Transverse Ridging

Definition/Etiology

Answer 21

Transverse depressions often more in central

portion of nail plate

Question 22

Transverse Ridging

Associated Disease

Answer 22

Serious acute illness slows nail growth (when
present in all nails = Beau’s lines), eczema,
chronic paronychia, trauma

Question 23

Transverse White Lines

Definition/Etiology

Answer 23

Bands of white discolouration

Question 24

Transverse White Lines

Associated Disease

Answer 24

Poisons, hypoalbuminemia (Muehrcke’s lines)

Question 25

Yellow Naila Associated Disease

Answer 25

Tinea, jaundice, tetracycline, pityriasis rubra pilaris, yellow nail syndrome, psoriasis, tobacco use

Question 26

Green Nails | Associated Disease

Answer 26

Pseudomonas

Question 27

Black Nails Associated Disease

Answer 27

Melanoma, hematoma

Question 28

Brown Nails Associated Disease

Answer 28

Nicotine use, psoriasis, poisons, longitudinal | melanonychia (ethnic)

Question 29

Splinter Hemorrhages | Definition/Etiology

Answer 29

Extravasation of blood from longitudinal vessels of nail bed, blood attaches to overlying nail plate and moves distally as it grows

Question 30

Splinter Hemorrhages | Associated Disease

Answer 30

Trauma, bacterial endocarditis, blood | dyscrasias, psoriasis

Question 31

Oil Spots | Definition/Etiology

Answer 31

Brown-yellow discolouration

Question 32

Associated Disease

Answer 32

Psoriasis

Question 33

Herpetic Whitlow | Definition/Etiology

Answer 33

HSV infection of distal phalanx

Question 34

Paronychia | Definition/Etiology

Answer 34

Local inflammation of the nail fold around the | nail bed

Question 35

Paronychia | Associated Disease

Answer 35

Acute: painful infection Chronic: constant wetting (e.g. dishwashing, thumbsucking)

Question 36

Nail Fold Telangiectasias | Definition/Etiology

Answer 36

Cuticular hemorrhages, roughness, capillary | changes

Question 37

Nail Fold Telangiectasias | Associated Disease

Answer 37

Scleroderma, SLE, dermatomyositis

Question 38

Temporary Loss | Definition/Etiology

Answer 38

Occurs without scarring

Question 39

Temporary Loss | Associated Disease

Answer 39

Trauma (especially toenails or fingernails after large subungal hematoma), Beau’s lins after severe illness

Question 40

Permanent Loss | Definition/Etiology

Answer 40

Occurs with scarring

Question 41

Permanent Loss | Associated Disease

Answer 41

``` Lichen planus (pterygium), genetic abnormalities (rare) ```