Nail Formation Disorders: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing).
      • Nails In exogenous (external) nail formation disorders:
        • Nail bed hematoma (bruise under the nail, leads to black discoloration of the nails).
        • Leukonychia striata or Mees stripes (white horizontal stripes).
        • Leukonychia punctata (punctate white coloration).
        • Onychogrypose (claw nails)
        • Longitudinal grooves of the nails can occur after frequent injuries or blunt damage
        • Brittle nails

        In endogenous (external) nail formation disorders:

        • Eczema nails
        • Nail fold changes
        • Nail dystrophy (completely destroyed nail plate)
        • Nail loss
        • Beau lines (transverse grooves of the nails)
        • Spoon nails (nails that are transversely and longitudinally concave, resembling a spoon shape).
        • Watch glass nails (the nails are distended piston-shaped because of the thickening of the finger end links, larger, roundish in shape and strongly curved outward).
        • Yellow-nail syndrome (yellowish discolored nails).
        • Half-and-half-nails (nails half brownish-red and white).
        • Melanochia striata (brown, striped longitudinal coloration – this necessarily clarified by a doctor, as it may be a tumor under the nail, such as malignant (malignant) melanoma).
      • Sclerae (white part of the eye)
      • Auscultation (listening) of the heart [congenital heart defects, valvular heart defects].
      • Auscultation of the lungs [due todifferential diagnoses: asbestosis (pneumoconiosis (dust lung disease) belonging to the lung disease caused by inhaled asbestos dust); bronchiectasis (synonym: bronchiectasis; permanent outpouchings of the bronchi, which can occur congenitally or acquired as a result of inflammation); chronic obstructive pulmonary disease (COPD)]
  • Dermatological examination including dermoscopy (reflected light microscopy) [due todifferential diagnoses:
    • Alopecia areata (circular hair loss).
    • Atopic eczema (neurodermatitis)
    • Dystrophia unguium mediana canaliformis (hereditary nail growth disorder).
    • Eczema (skin inflammation associated with pruritus (itching) and erythema (areal redness of the skin).
    • Lichen ruber planus (nodular lichen)
    • Paronychia congenita (genetic disease of the nails associated with other hair abnormalities such as hyperhidrosis (increased sweating) and changes in the mucous membranes).
    • Psoriasis (psoriasis)
    • Vitiligo (white spot disease)]
  • Cancer prevention
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.