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Related Concept Videos

Accessory Structures of the Skin: Nails01:05

Accessory Structures of the Skin: Nails

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Related Experiment Video

Updated: May 22, 2026

Non-Invasive Visualization of Nailbed Microvascular Morphology in Mice Using Capillaroscopy
05:06

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Published on: February 28, 2025

Evaluation of nail abnormalities.

Amber S Tully1, Kathryn P Trayes, James S Studdiford

  • 1Cleveland Clinic, Stongsville, OH, USA. tullya@ccf.org

American Family Physician
|April 27, 2012
PubMed
Summary
This summary is machine-generated.

Nail abnormalities can indicate serious health issues. Recognizing specific nail changes like excessive keratin, masses, or deformities is crucial for diagnosing conditions from fungal infections to systemic diseases.

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Area of Science:

  • Dermatology
  • Internal Medicine
  • Pathology

Background:

  • Physical examination of the nail apparatus is vital for diagnosis.
  • Nail abnormalities can be localized or indicative of systemic disease.
  • Understanding nail anatomy aids in identifying pathological conditions.

Purpose of the Study:

  • To highlight the diagnostic significance of various nail abnormalities.
  • To correlate specific nail findings with potential underlying medical conditions.
  • To guide clinicians in evaluating nail changes during physical examinations.

Main Methods:

  • Visual inspection of the nail apparatus.
  • Diagnostic procedures including potassium hydroxide (KOH) examination, nail cultures, and nail plate biopsies.
  • Correlation of clinical findings with systemic diseases.

Main Results:

  • Excessive keratin suggests onychomycosis, diagnosed via KOH or culture/biopsy.
  • Nail masses require evaluation for squamous cell carcinoma.
  • Longitudinal melanonychia must be differentiated from subungual melanoma.
  • Clubbing, koilonychia, splinter hemorrhages, Beau lines, Muehrcke lines, and pincer nails are associated with specific systemic diseases or local conditions.

Conclusions:

  • Nail examination is a critical component of a comprehensive physical assessment.
  • Specific nail findings serve as important diagnostic clues for a range of conditions, from infections to malignancies and systemic illnesses.
  • Prompt recognition and evaluation of nail abnormalities can lead to timely diagnosis and management of underlying diseases.