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Acquired pincer nail deformity associated with renal failure
The Journal of Clinical and Aesthetic Dermatology
|December 23, 2011
Summary
Pincer nail deformity, a nail shape change, can occur with kidney disease. In this case, it developed in a patient with end-stage renal disease undergoing hemodialysis, possibly due to an arteriovenous fistula.
Area of Science:
- Nephrology
- Dermatology
- Oncology
Background:
- Pincer nail deformity is characterized by a loss of the normal convex nail shape.
- It has been associated with various systemic diseases and pharmacologic agents.
- End-stage renal disease (ESRD) is a potential contributing factor to nail abnormalities.
Observation:
- A case of pincer nail deformity is presented in a male patient with ESRD secondary to bladder carcinoma.
- The patient was undergoing hemodialysis treatment.
- The development of pincer nail deformity occurred during hemodialysis therapy.
Findings:
- Unlike previous reports suggesting diabetes as a cause in renal failure patients, this patient was not diabetic.
- The nail dystrophy in this case is hypothesized to be linked to the arteriovenous fistula (AV fistula) created for hemodialysis access.
- This suggests AV fistula placement as a potential novel cause of pincer nail deformity in ESRD patients.
Implications:
- This case highlights a potential iatrogenic cause of pincer nail deformity in patients with end-stage renal disease.
- It expands the differential diagnosis for nail changes in patients undergoing hemodialysis.
- Further investigation may be warranted to confirm the association between AV fistulas and pincer nail deformity.
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