192 Nail changes
Salient features
• Terry’s nail (Fig. 192.1): brownish-red distal transverse band; occurs normally in the elderly, also seen in cirrhosis and congestive cardiac failure
• Lindsay’s half-and-half nail (Fig. 192.2): distal brown band occupying about 25–50% of the nail bed, and seen in chronic renal failure
• Muehrcke’s nail: pale transverse bands resulting from oedema of the nail bed; seen in hypoalbuminaemia
• Blue lunula: in Wilson’s disease the normally white lunula becomes blue (p. 437); the lunula has the largest area in the fingers closest to the thumb; in the elderly it becomes smaller or absent.
• Disorders of the nail plate:
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