Monday, July 7, 2008

24 - terry's nails

The distal 1–2-mm rim of the nail (which is still in contact with the nail bed) is pink, while the rest of the nail is white. This appears to be a non-specific sign, although in the patient shown it was associated with renal failure.

Terry's nails is a physical finding in which fingernails and/or toenails appear white with a characteristic "ground glass" appearance, with no lunula. The condition is thought to be due to a decrease in vascularity and an increase in connective tissue within the nail bed. It frequently occurs in the setting of hepatic failure, cirrhosis, diabetes mellitus, congestive heart failure, hyperthyroidism, and/or malnutrition. Eighty percent of patients with severe liver disease have Terry's nails.

In patients with Terry's nails, most of the nail plate turns white with the appearance of ground glass, and the lunula is obliterated. The condition may occur on only one finger, but more commonly all fingers are affected. This condition was described originally in relation to severe liver disease, usually cirrhosis, with 80 percent of these patients having Terry's nails. Subsequently, in another study, 25 percent of hospitalized patients with varied diseases were found to have Terry's nails. The condition is thought to be caused by a decrease in vascularity and an increase in connective tissue in the nail bed.

Hepatic failure, cirrhosis, diabetes mellitus, CHF, hyperthyroidism, malnutrition are the causes .

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