Do any systemic diseases have specific nail findings?

Many systemic diseases have characteristic, but not mutually exclusive, nail findings. Most nail changes are part of a symptom complex or a reaction pattern that may be extremely helpful in making a particular diagnosis (Table 68-1).

Scher RK, Daniel CR: Nails: therapy, diagnosis, surgery, ed 3: Philadelphia, 2005, WB Saunders.

Table 68-1. Nail Disorders in Systemic Disease
	NAIL ABNORMALITY		AREA INVOLVED		ASSOCIATED DISEASE
	Splinter hemorrhages		Bed		Bacterial endocarditis
	Mees’ lines		Plate		Arsenic exposure
	Muehrcke’s lines		Bed		Nephrotic syndrome
	Terry’s nails		Bed		Cirrhosis
	Half-and-half nails		Bed		Chronic renal failure
	Blue lunulae		Matrix		Wilson’s disease
	Red lunulae		Matrix		Rheumatoid arthritis
	Clubbing		Plate/matrix		Pulmonary disorders
	Spoon nails		Plate/matrix		Iron deficiency
	Nail fold telangiectasias		Nailfold		Scleroderma, systemic lupus
	Yellow nails		Plate		Pulmonary disorders, sinusitis