Nail morphology

Question 1

What is the DDx of splinter haemorrhages?

Answer 1

Trauma, but can signify infective endocarditis

Question 2

What is the DDx of clubbing?

Answer 2

Respiratory conditions: Interstitial lung diseases such as Pulmonary Fibrosis, Cystic Fibrosis, Cancer, Bronchiectasis, Genetic/Familial

Cardiac conditions: Tetralogy of Fallot, Congenital cyanotic heart disease, subacute bacterial endocarditis, Atrial myxoma (benign tumour)

GI and Hepatobiliary: Malabsorption, Crohn’s disease and Ulcerative Colitis, Cirrhosis especially Primary Biliary Cirrhosis

Unilateral clubbing: Vascular anomalies of the affected arm, such as axillary artery aneurysm

Question 3

Define Koilonychia. DDx of Koilonychia.

Answer 3

Koilonychia is the spoon-shaped depression of nail plate.

DDx: Iron deficiency anaemia, lichen planus, repeated exposure to detergents