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Terry nails - Nail and Distal Digit
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Terry nails - Nail and Distal Digit

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Contributors: Noah Craft MD, PhD, Bertrand Richert MD, Robert Baran MD
Other Resources UpToDate PubMed

Synopsis

Terry nails exhibit a ground-glass-like opacity and appear pale or white for almost the entire nail bed except for a 1- to 2-mm distal band of normal pink or brown color. In a revised definition of Terry nails, the distal brown band is four times more frequent than a pink band.

Terry nails is the classic nail finding that occurs in about 80% of patients with cirrhosis (other nail findings of cirrhosis include curved nails with or without clubbing and cyanosis of the fingers, flattening of the nail, longitudinal ridging, and nail thickening). Terry nails is seen in other hypoalbuminemic and malnourished states, including renal failure, diabetes, and congestive heart failure. It has been associated with aging; in young individuals, Terry nails should prompt consideration of systemic disease.

Codes

ICD10CM:
L60.8 – Other nail disorders

SNOMEDCT:
402629005 – Nail changes associated with systemic disease

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Half-and-half nails, also known as Lindsay nails (uremic)
  • Muehrcke lines
  • Hemochromatosis
  • Kashin-Beck disease (a poorly understood disorder seen in Asia; due to excessive amounts of iron in the water supply)

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 01/19/2015
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Terry nails - Nail and Distal Digit
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Terry nails : White color, Proximal 2/3 of Nails White
Clinical image of Terry nails
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