ABSTRACT
Nail examination provides important clues to not only dermatological diseases but also underlying systemic disorders, at times, even before appearance of other symptoms. Nail findings when carefully observed can be valuable, since they are readily perceived. Nail changes can be helpful in diagnosis of certain disorders or can provide confirmation in some. Nail changes can be specific or non-specific. They limit the differential diagnosis and assist in avoiding expensive work up. This chapter provides in detail the information of nail changes in terms of changes in nail shape like koilonychia, clubbing, pincer nails, pterygia, anonychia, and micronychia; nail surface like pitting, Beau’s lines; nail color like splinter hemorrhages, cyanosis, Mees’ lines; nail attachment like onycholysis, onychomadesis, and their relation with systemic disorders, i.e., diseases of cardiac, respiratory, infectious, gastrointestinal, genitourinary, reproductive, hepatic, renal, endocrine, central, and peripheral nervous, musculoskeletal, hematological, connective tissue, immunological, nutritional, metabolic systems, and toxicities. In this chapter nail signs with specific genodermatoses are also described. So, this chapter can be valuable for clinicians to familiarize them with nail changes which can often act as a harbinger of many associated systemic disorders, providing an inexpensive and clinical tool to make many difficult diagnoses in clinical practice.
