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Assessment – Nutrition-Focused Physical Exam to Detect Micronutrient Deficiencies
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Nails exhibiting koilonychia have a spoon-shaped appearance, which may be caused by iron deficiency with or without anemia (see Figure 7.16). Possible non-nutrient causes include hemochromatosis, diabetes mellitus, hereditary factors, Raynaud’s disease and trauma.2,4
Nails—Koilonychia
Published in Charles Theisler, Adjuvant Medical Care, 2023
Koilonychia is a flat and spoon-shaped nail plate associated with iron deficiency anemia. A central nail plate ridge can arise from iron deficiency, folic acid deficiency, or protein deficiency.1 SLE, hemochromatosis, and Raynaud's disease can also cause koilonychia.
Radiation and the nail
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
The second state presents with keratosis and atrophic skin with telangiectasia surrounding the dorsum of the plate. The latter becomes brownish, thickened, or thin with fissures of the free edge. Sometimes, the nail becomes opaque and brittle with koilonychia, or on the contrary with onychogryposis. The free edge can be elevated by a subungual wart. Those warts are sometimes annoying and even painful. The coal spots follow the extremely slow nail growth and may appear as longitudinal melanonychia. Paronychial infection is a painful complication, inflammatory or more often suppurating, or associated with dermatitis of the dorsal aspect of the terminal phalanx. Finally, infection reaches the subungual area, which becomes very painful. It can lead to nail avulsion which reveals an atonic ulceration.
Recognizing skin conditions in patients with cirrhosis: a narrative review
Published in Annals of Medicine, 2022
Ying Liu, Yunyu Zhao, Xu Gao, Jiashu Liu, Fanpu Ji, Yao-Chun Hsu, Zhengxiao Li, Mindie H. Nguyen
Koilonychia (Figure 2(j)) (spoon-shaped nails) is a disorder in which nail plates are concave centrally and raised laterally. Water droplets can converge on the hollow nail plate and can serve as a useful diagnostic tool [52]. Chinazzo et al. performed a prospective observational study and found that the prevalence of koilonychia in healthy newborns was 32.7% [53]. While the abnormality is a natural variant, it is associated with iron deficiency anaemia, hemochromatosis, coronary disease, hypothyroidism and cirrhosis, giving diagnostic clues to these conditions when present in an appropriate context [43].