Terry's Nails: A Sign of Systemic Disease

Area of Science:

• Dermatology
• Internal Medicine
• Nail Disorders

Background:

• Terry's nails present as apparent leukonychia with characteristic nail bed opacification and lunula obliteration.
• This nail finding can be associated with normal aging or significant systemic conditions.

Purpose of the Study:

• To review and synthesize current data on Terry's nails since their initial description in 1954.
• To guide clinical practice regarding diagnosis, associated conditions, and workup for Terry's nails.

Main Methods:

• Systematic literature search of PubMed using keywords "leukonychia" and "Terry nails."
• Review of clinical features, associated medical conditions, pathogenesis, and diagnostic workup.

Main Results:

• Terry's nails can be linked to cirrhosis, chronic renal failure, and congestive heart failure.
• Pathogenesis is thought to involve changes in nail bed vascularity and connective tissue overgrowth.
• Differential diagnosis includes Lindsay's nails, Muehrcke's nails, and true leukonychia.

Conclusions:

• Terry's nails serve as a valuable clinical indicator of systemic disease.
• Distinguishing Terry's nails from other leukonychia types is important for patient management.
• Thorough nail examination is essential during physical assessments.