Overview
Patients with chronic kidney disease may exhibit signs in the nails such as leukonychia or onycholysis.
Leukonychia
Look For
- Whiteness of the nail beds.
Interpretation
True Leukonychia
- Total leukonychia: generalised whitening of the nails.Inherited - rare
- Transverse leukonychia (Mee's lines): single white bands running parallel to the nail base, that do not disappear when depressed.Intermittent insult during nail growth - arsenic, chemotherapy, trauma, infection
Apparent Leukonychia
- Muehrcke's lines: double white bands that disappear when the nail is depressed.Chronic hypoalbuminaemia
- Half and half nails (Lindsay's nails): proximal white nail bed and distal brown nail, separated by a transverse ridge.Uraemia
- Terry's nails: white proximal nail bed with loss of the lunula (proximal white crescent-shaped area).Cirrhosis, CCF, diabetes, malnutrition, renal transplant
Onycholysis
Look For
- Separation of the nail from the nail bed, either distally or laterally.
Causes of Onycholysis
- Systemic disease - chronic kidney disease, bronchial carcinoma, anaemia, diabetes mellitus, porphyrias, peripheral vascular disease, thyrotoxicosis
- Nail infection
- Skin disease - psoriasis, dermatitis, lichen planus
- Trauma
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------