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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: Shari Lipner MD, PhD, Noah Craft MD, PhD, Susan Burgin 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 4 times more frequent than a pink band.

Terry nails are 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 are seen in systemic diseases, including renal failure, diabetes, and congestive heart failure. The association with hypoalbuminemia is controversial. Terry nails have been associated with aging, particularly in patients with a systemic disease. In a patient younger than 50 years, clinical findings consistent with Terry nails should prompt workup for a 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 (hypoalbuminemia)
  • Hemochromatosis
  • Kashin-Beck disease (a poorly understood disorder seen in Asia, due to excessive amounts of iron in the water supply)
  • Mees' lines (arsenic poisoning)

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 10/28/2019
Last Updated: 11/06/2019
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Terry nails - Nail and Distal Digit
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Terry nails : Leukonychia, Proximal 2/3 of Nails White
Clinical image of Terry nails
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