Overview
The nails can reveal signs suggestive of haematologic disease. While pallor of the nail bed is a sign of anaemia, koilonychia suggests potential iron deficiency.
Pallor of the Nail Bed
Whitening of the nail beds is classically a sign of anaemia, though may also occur in the context of poor peripheral perfusion.
Causes of Pallor of the Nail Bed
- Anaemia
- Low cardiac output, due to cardiac disease
- Peripheral shutdown, due to increased sympathetic activity.
Koilonychia
Look For
- Spoon-shaped nails.
Significance
- May be an indicator of iron deficiency anaemia.
Causes of Koilonychia
- Chronic iron deficiency
- Upper GI carcinoma
- High altitude
- Trauma
- Hypothyroidism
- Systemic lupus erythematosus
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