Related Experiment Videos
The harlequin nail. A marker for smoking cessation
1Department of Medicine, Veterans Administration Medical Center, Johnson City.
Chest
|January 1, 1990
Summary
A new "harlequin nail" sign indicates smoking cessation due to illness, like a stroke. Measuring this nail change can help estimate when a patient stopped smoking.
Area of Science:
- Dermatology
- Clinical Medicine
- Public Health
Background:
- Nail changes often signal underlying health issues, both local and systemic.
- Chronic smoking causes nail alterations, including yellowing (nicotine sign).
- A clubbed yellow nail can be an indicator of lung cancer.
Observation:
- Sudden smoking cessation due to intercurrent disease, such as cerebrovascular accident (CVA), results in a distinct nail demarcation.
- This sign presents as a line separating distal pigmented nail from newly emerging proximal nonpigmented nail.
- We propose the term "harlequin nail" for this observation.
Findings:
- The "harlequin nail" sign is a propitious indicator of smoking cessation.
- The distance from the proximal nail fold to the demarcation line correlates with the time smoking ceased.
- This measurement can help approximate the date of a cerebrovascular accident (CVA) in patients unable to provide history.
Implications:
- The "harlequin nail" sign offers a method to estimate smoking cessation timing.
- This can indirectly aid in dating cerebrovascular accidents (CVAs) in non-communicative patients.
- It highlights that "nicotine nails" are discolored due to ongoing tobacco staining.