Gbe. Jemec et al., NAIL ABNORMALITIES IN NONDERMATOLOGIC PATIENTS - PREVALENCE AND POSSIBLE ROLE AS DIAGNOSTIC AIDS, Journal of the American Academy of Dermatology, 32(6), 1995, pp. 977-981
Background: Nail changes have traditionally been used as diagnostic ai
ds. Their usefulness in general and predictive value in particular, ho
wever, is not known. Objective: Our purpose was to survey nail changes
and to clarify the potential of nail abnormalities to diagnose nonder
matologic diseases. Methods: The fingernails of 567 patients admitted
to general medical and surgical wards were examined. The point prevale
nce rates were calculated on the basis of a binomial distribution. The
results were compared with the diagnosis with logistic regression ana
lysis correcting for age and sex. Results: The most common findings we
re absence of lunulae (22.9% [19.5% to 26.6%]), white nails or apparen
t leukonychia (11.8% [9.3% to 14.8%]), and red lunulae (5.1% [3.5% to
7.3%]). The following significant associations were noted: pulmonary d
isease and clubbing (odds ratio[OR] = 4.1, 95% confidence interval [CI
] = 1.7 to 9.5), hematologic disease and brittle nails (OR = 4.6, 95%
CI = 1.6 to 13.7), hematologic disease and Terry nails (OR = 8.7, 95%
CI = 2.7 to 27.0), gastrointestinal disease and pincer nails (OR = 33.
6, 95% CI = 3.7 to 307.3), and gastrointestinal disease and subjective
complaints (OR = 2.7, 95% CI = 1.4 to 5.0). Conclusion: Several signi
ficant associations were identified, suggesting that nail abnormalitie
s can be diagnostic clues in the diagnosis of chronic nondermatologic
diseases. An association between pincer nails and gastrointestinal dis
ease has not been previously described.