Nail abnormalities in Dermatology

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RIDL (Random Irregular Deep Large) pitting: Psoriasis

Regular/ Geometric pitting: Alopecia areata

Large pits: Eczema

NAIL PSORIASIS:
1. Salmon patch/ Oil drop sign (Pathognomonic)
2. Sub-ungual hyperkeratosis
3. Onycholysis
4. Punctate leukonychia (milk spot).

NAIL LICHEN PLANUS:
1. Longitudinal ridge
2. Tented nail
3. Thinning of nail plate
4. Distal pterygium (extension of proximal nail fold to nail bed: Classical finding)
5. 20 nail dystrophy (Trachyonychia/ Sand paper nail).

INVERSE/ VENTRAL PTERYGIUM:
– Seen in Scleroderma
– Adherence of the distal portion of nail bed to ventral surface of nail plate.

HALF & HALF NAIL:
– Seen in Chronic renal failure
– Proximal part white and distal part brown (due to melanin deposition).

TERRY’S NAIL:
– Seen in Cirrhosis
– Cause: Hypoalbuminemia
– Proximal part white and distal part red.

MEE’S LINE:
– Seen in Arsenic poisoning
– Alternate red and white lines on nail.

BEAU’S LINE:
– Indicates recent fever
– Horizontal groove on nail plate.

 

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