Pathology: leukonychia

Leukonychia, or “white nail” is sometimes found in liver disease.  In particular, it may be an indication of hypoalbuminemia.  With a high pre-test probability of late-stage disease (ie. thrombocytopenia, hyponatremia) synthetic dysfunction may be reflected in the nail exam. 

Remember to begin your physical exam with a careful inspection of the hands! Not only can you find leukonychia, but you may detect signs like palmar erythema, Dupuytren’s contracture, poor hygiene and a rapid radial pulse (subtherapeutic beta blockade). 

In the image above, note the pallor of the nail; it extends almost to the top.

Advertisements
This entry was posted in Pathology. Bookmark the permalink.

Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s