Nail Examination | Hand & Wrist Exam - MedSchool
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Hand & Wrist Exam
 
 
Hand & Wrist Exam
Examination of the nails may reveal pathognomonic signs suggestive of rheumatologic disease.
 

Nail Examination

 
 

Overview

  • Examination of the nails may reveal pathognomonic signs suggestive of rheumatologic disease.

Onycholysis

    • Look For

    • Separation of the nail from the nail bed, either distally or laterally.
    • Causes of Onycholysis

    • Skin disease - psoriasis, dermatitis, lichen planus
    • Nail infection
    • Trauma
    • Systemic disease - chronic kidney disease, bronchial carcinoma, anaemia, diabetes mellitus, porphyrias, peripheral vascular disease, thyrotoxicosis

Nail Pitting

    • Look For

    • Pin-point depressions in the nail plate.
    • Causes of Nail Pitting

    • Eczema
    • Psoriasis
    • Reactive arthritis
    • Alopecia areata
    • Sarcoidosis

Splinter Haemorrhages

    • Look For

    • Painless longitudinal red / brown lines between 1-3mm on the nail bed.
    • Causes of Splinter Haemorrhages

    • Trauma
    • Infective endocarditis
    • Vasculitis - rheumatoid arthritis, antiphospholipid syndrome, systemic lupus erythematosus, Behcet disease
    • Skin conditions - psoriasis, lichen planus
Last updated on May 9th, 2019
 
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