DIAGNOSIS BY NAILS – Contributed by: Dr Gurjit Kaur

DIAGNOSIS BY NAILS

Fingernails and What They Reveal

Dr. Gabrielle Traub

“Ridges can signify a possible infection such as the flu.”

Contributed by: Dr Gurjit Kaur
E-mail id: dr.gurjitkaur@yahoo.com
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NAIL LINES

1. 1. BEAU’S LINES: Transverse depressions. Occurs when growth at the nail root (matrix) is interrupted by any severe acute illness e.g. heart attack, measles, pneumonia, or fever. These lines emerge from under the nail folds weeks later, and allow us to estimate when the patient was sick.

Repertory:

• NAILS; corrugated; transversely: ars., med

1. 2. MEE’S LINES: Transverse white lines that run across the nail, following the shape of the nail moon. Uncommon. Causality: after acute/severe illness, Arsenic poisoning.

Repertory: Ars alb

1. 3. VERTICAL RIDGES: (Lengthwise grooves or ridges) – may indicate a kidney disorder (kidney failure); associated with ageing; iron deficiency (Anemia). May indicate a tendency to develop arthritis

Repertory:

• NAILS; roughness fingernails; ridges, longitudinal: fl-ac.
• NAILS; roughness fingernails; ribbed: thuj.
• NAILS; corrugated: ars., calc., calc-f., fl-ac., med., ph-ac., sabad., sel., Sil., thuj.

NAIL SHAPE

1. 1. CLUBBING OF THE FINGERS: fingertips widen and become round. Nails curve around your fingertips, more convex. Proximal nail fold feels spongy. Caused by enlargement in connective tissue as compensation for a chronic lack of oxygen. e.g. severe emphysema Lung disease is present in 80 percent of people who have clubbed fingers. It may also appear in chronic infections especially abscesses, lung cancer, chronic lung (chronic bronchitis, emphysema) and heart disease, longstanding TB, congenital heart disease, cyanotic, primary biliary cirrhosis.

Repertory: nit-ac., tub.

• Curved fingernails; consumption, in: med., tub.

1. 2. PITTING: Small pits or depressions. It is a most common nail problem seen in 25 percent to 50 percent of people with psoriasis

Repertory:

• Extremities; NAILS; holes in: ars.
• Psoriasis – pitting, onycholysis, thickening, circumscribed yellowish tan discoloration “oil spot” lesion.

1. 3. SPOON NAIL: Soft nails that look scooped out. Depression is usually large enough to hold a drop of liquid. Often indicates iron deficiency anemia.

Repertory: Extremities; NAILS; complaints of; depressed: med.

1. 4. ONYCHOLYSIS: Lifting of the nail from the nail bed. Causes: trauma, psoriasis, drug reactions, bacterial/fungal infection, contact dermatitis from using nail hardeners, thyroid disease, iron deficiency anemia or syphilis.

Repertory: Looseness fingernails: apis., med., pyrog., ust.
NAIL GROWTH

1. 1. NAIL HYPERTROPHY: Thickening of the nail. Either congenital (e.g. Mal de Meleda) or acquired – The nail becomes deformed with claw like appearance. Causes: Not cutting the nails, trauma, Leprosy, peripheral vascular disorders.

Repertory:

• NAILS; hypertrophy: calc-f., fl-ac., graph., laur.
• NAILS; thick: alum., anan., ant-c., ars., but-ac., calc., calc-f., calo., caust., falco-p., ferr., fl-ac., Graph., merc., pitu-a., pop-c., sabad., sec., sep., Sil., sulph., ust., x-ray

1. 2. NAIL ATROPHY: The nail becomes thin, rudimentary and smaller size congenital or acquired. Causes: Lichen planus, Epidermolysis bullosa, Darrier‘s disease, vascular disturbances, Leprosy.

Repertory:

• NAILS; atrophic: sil.
• NAILS; grow, do not: ant-c., pitu-a., rad-br., sil.

1. 3. NAIL PATELLA SYNDROME: a rare genetic disorder, occurs in 2.2 out of every 100,000 people and causes abnormalities in the bones and nails. autosomal dominant. Carried by the ABO blood group. Nails present as small and concave, longitudinally grooved, abnormally split, pitted, softened, discolored, or brittle.

Repertory:
Remedies: Thuja, Graphites, Calc-flour, Syph.
H; Hands; NAILS, fingers, general; grow, nails, do not: ant-c., calc., sil.
DISCOLORATION

1. 1. LINDSAY’S NAILS (HALF AND HALF) — Look for an arc of brownish discoloration. May occur in a small percentage of people who have kidney failure. Internal diseases and nutritional deficits can cause changes in the appearance of the nails.

1. 2. TERRY’S NAILS: The nail looks opaque and white, but the nail tip has a dark pink to brown band. May accompany cirrhosis, congestive heart failure, adult-onset diabetes, cancer or ageing.

1. 3. CYANOSIS: A bluish discoloration visible at the nail bases in select patient with severe hypoxemia or hypoperfusion. As with clubbing, it is not at all sensitive for either of these conditions.

Repertory:

• H; Hands; NAILS, fingers, general; discoloration, nails; blueness (59) : acon., aesc., agar., apis, apoc., arg-n., arn., ars., asaf., aur., cact., camph., carbn-s., carb-v., chel., chin., chin-ar., chin-s., chlf., cic., cocc., colch., con., cupr., dig., dros., eup-pur., ferr., ferr-ar., ferr-p., gels., gins., graph., ip., manc., merc., merc-s., mez., mur-ac., nat-m., nit-ac., Nux-v., op., ox-ac., petr., ph-ac., phos., plb., rhus-t., sang., sars., sep., sil., sulph., sumb., tarent., thuj., Verat., verat-v.

PARONYCHIA (FELON)
Inflammation of the nail folds, which appear red, swollen and tender. The cuticle may not be visible. Causes: fungal infection, secondary bacterial infection, people who’s hands are often in water are more susceptible.
Repertory:

• Hands; NAILS, fingers, general; panaritium, nails (53) : all-c., alum., Am-c., am-m., anac., Anthr., Apis, arn., asaf., bar-c., benz-ac., berb., bov., bufo, calc., caust., chin., cist., con., cur., Dios., eug., ferr., Fl-ac., gins., Hep., hyper., iod., iris, kali-c., kalm., lach., led., lyc., merc., Myris., nat-c., nat-h., nat-m., nat-s., Nit-ac., par., petr., phyt., plb., puls., rhus-t., sang., sep., Sil., sulph., Tarent-c., teucr.
• NAILS; pulp, of; nails recede, leave raw surface: sec.
• Redness; fingernails: apis, ars., cortiso., crot-c., lepi., lith-c., ozone, upa., x-ray
• Inflammation, fingernails; around: con., hell., kola., nat-m., nat-s., ph-ac., sil.
• Hands; NAILS, fingers, general; fungus, under (4) : ant-c., graph., petr., thuj.
• Hands; NAILS, fingers, general; inflammation, fingernails (1) : kali-c.
• Hands; NAILS, fingers, general; inflammation, fingernails; root of (2) : hep., stict.

SPLINTER HAEMORRHAGES
Looks like a splinter underneath the nail, virtually 100% diagnostic of Sub-acute Bacterial Endocarditis (SBE). A bacterial infection affecting the valves of the heart. Occasionally caused by Trichinosis, a parasitic infection caused by eating raw or undercooked Pork.
Repertory:

• Diseases; ENDOCARDITIS, heart: abrot., acet-ac., Acon., Ars., ars-i., Aur., aur-m., bism., bry., cact., calc., cocc., coc-c., colch., dig., ferr., iod., kali-ar., kali-c., kali-i., Kalm., lach., led., nat-m., naja, ox-ac., phos., phyt., plat., plb., sep., Spig., spong., tarent., verat-v.
• Diseases; TRICHINOSIS (3) : ars., bapt., cina

YELLOW NAIL SYNDROME
Yellow nail syndrome is characterized by yellow or green nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis). May be associated with swelling of the hands and feet (lymphoedema), or a lung diseases e.g. chronic bronchitis. Yellow nails can indicate internal disorders long before other symptoms appear. Some of these are problems with the lymphatic system, respiratory disorders, diabetes, and liver disorders.
Repertory:

• NAILS: discoloration; yellowish: am-c., ambr., ant-c., ars., aur., bell., bry., calc., canth., carb-v., caust., cham., chel., chin., Con., ferr., hep., ign., lyc., merc., nit-ac., nux-v., op., plb., puls., Sep., Sil., spig., sulph.

WHITE SPOTS (LEUKONYCHIA)
Caused by trauma to the nails, over vigorous/excessive manicuring
Repertory: alum., ars., nit-ac., ozone, sep., Sil., sulph., thal.


MELANONYCHIA
Vertical pigmented bands or nail ‘moles‘. A sudden change in the nail plate could indicate a malignant melanoma or lesion. Commonly occur in dark-skinned people, and are normal.
BRITTLE NAILS

• Hypothyroidism: brittle nails – which separate easily from the nail bed (Onycholysis) accompanied by dry, yellowish skin, fatigue, slow pulse, chilly, coarse hair that falls out.
• Hyperthyroidism: brittle nails – which separate easily from the nail bed (Onycholysis) and are concave (spoon nails)
• Brittle nails – may also suggest iron deficiency anemia, kidney and circulatory problems.

Repertory:

• NAILS; brittle: alum., alum-sil., ambr., anan., ant-c., ars., but-ac., calc., calc-f., cast-eq., caust., clem., cupr., dios., fl-ac., Graph., hep., hydrog., lept., lyc., med., merc., morg., nat-m., nit-ac., ozone, phos., Psor., rad-br., ruta, sabad., sec., sel., senec., sep., sil., spig., squil., sulph., syc-co., thuj., tub., x-ray
• Nails that chip, peel, crack, or break easily – suggest a nutritional deficiency, lacking hydrochloric acid, protein or minerals.
• NAILS: cracked: ant-c., ars., lach., nat-m., sil.
• Crumbling away of fingernails: but-ac.{Butyric acid: a volatile acid obtained from butter}
• NAILS; scatter like powder when cut: sil.

SUMMARY

• Liver Diseases: White Nails
• Kidney Diseases: Half of nail is pink, half is white
• Heart Conditions: Nail bed is red
• Lung Diseases: Yellowing and thickening of the nail, slowed growth rate
• Anemia: Pale nail beds
• Diabetes: Yellowish nails, with a slight blush at the base
• Nutritional deficiencies
  • Vitamin A and calcium deficiencies – dry brittle nails.
  • Vitamin B deficiency – horizontal and vertical ridges, that break easily.
  • Vitamin B12 deficiency – dry, darkened nails with rounded and curved nail ends.
  • Protein deficiency – white bands

AYURVEDIC ANALYSIS
Ayurveda considers nails as the waste product of the bones.
Dry, crooked, rough nails that break easily indicates a predominance of the Vata constitution.
Soft, pink, tender nails that are easily bent are indication of a Pitta constitution.
Thick, strong, soft and shiny nails indicate a Kapha constitution.
Longitudinal lines: indicate inability of the digestive system to absorb food properly.
Transverse grooves: may indicate the presence of long-standing illness or malnutrition.
Yellow nails: alert us to liver problems or jaundice.
Blue nails: indicate a weak heart.
Redness: shows an excess of red blood cells.