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Nails
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
White Pallor of the nail bed proximally with a brownish-pink rim distally (Terry nails) occurs in several medical conditions such as hypoalbuminemia, chronic renal failure, cirrhosis, congestive cardiac failure, zinc deficiency and hyperthyroidism.
Nail changes due to systemic drugs
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
It can present in three forms: half-and-half nail (two parts of nail transversally separated by a well-defined border), Muehrcke’s (paired narrow white bands that are separated from each other and from the lunula by pink bands of nail), and Terry’s nails (nails are an opaque white color that stops 1–2 mm from the distal edge of the nail leaving a pink to brown area 0.5–3.0 mm wide, parallel to the distal part of the nail bed) (Figure 23.7).1–3
General physical examination
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Terry’s nails (nail tips having dark pink or brown bands):1 Old age (>75 yr).2 CCF.3 Cirrhosis of liver.4 DM.5 Malignancy.
Development of Terry’s nails after a gastrointestinal bleed
Published in Baylor University Medical Center Proceedings, 2021
Christine P. Lin, Mahmud Alkul, Jay M. Truitt, Cloyce L. Stetson
Terry’s nails, a type of apparent leukonychia, is a sign of systemic disease characterized by ground-glass opacity of nearly the entire nail with a narrow band of normal pink or brown nail bed at the distal plate.1 Nail involvement is often bilaterally symmetrical.1,2 Terry’s nails were first described in 1954 by Richard Terry in patients with hepatic cirrhosis.3 Subsequent studies have demonstrated this nail abnormality to be associated with congestive heart failure, chronic kidney disease, diabetes mellitus, and malnutrition.1,2,4 Because Terry’s nails may signify underlying disease, a careful clinical exam is essential in every patient encounter. We report a case of a 77-year-old man who developed Terry’s nails following an acute gastrointestinal bleed and subsequent hemorrhagic shock.
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
Terry’s nails (Figure 2(a–c)) are characterized by the presence of a white nail bed, a distal brown to pink transverse band of 0.5–2.0 mm in width, and the absence of lunulae [29–31]. First reported by Terry in 1954, this condition is a cardinal sign of hepatic cirrhosis [29,32]. However, Holzberg and Walker found a strong correlation between Terry’s nails and congestive heart failure as well as adult-onset diabetes mellitus in addition to cirrhosis in their study of 512 hospitalized patients [33]. Hyperthyroidism, malnutrition, renal failure and Reiter syndrome have also been associated with Terry’s nails [15,34]. In addition, Terry’s nails are associated with ageing in populations without known systemic diseases [33].