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Journal of General Internal Medicine

, Volume 33, Issue 7, pp 1018–1019 | Cite as

Terry’s Nails: Clinical Correlations in Adult Outpatients

  • Nick Nelson
  • Kweku Hayfron
  • Alejandro Diaz
  • Scott Lynch
  • Irene Yen
  • Allison Bakamjian
  • Indhu Subramanian
Concise Research Reports

INTRODUCTION

The nails have a rich history as windows into systemic disease, beginning with Hippocrates’ observation of digital clubbing as a sign of empyema in the 5th century BCE. 1 In 1954, Richard Terry added to this tradition the sign which bears his name when he reported “a ground-glass-like opacity of almost the entire nail bed”. 2 He observed this abnormality most frequently in patients with cirrhosis, but also in cases of congestive heart failure (CHF), diabetes, tuberculosis, rheumatoid arthritis, systemic sclerosis, some cancers, and in normal, healthy children up to age four. 2 1 Terry’s nails have also been reported in reactive arthritis, renal transplant patients, POEMS syndrome, and leprosy, and have recently been promoted as one of the most reliable physical signs of cirrhosis 3 (Fig.  1).

KEY WORDS

diagnosis gastroenterology primary care physical examination cirrhosis 

Notes

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have do not have a conflict of interest.

References

  1. 1.
    Hippocrates; Ducachet HW. The Prognostics and Crises, London: James Eastburn and Co.; 1819: 51.Google Scholar
  2. 2.
    Terry R. White nails in hepatic cirrhosis. Lancet. 1954; 266:757–759CrossRefPubMedGoogle Scholar
  3. 3.
    Udell JA et al. Does this patient with liver disease have cirrhosis? JAMA. 2012; 307:832–842CrossRefPubMedGoogle Scholar
  4. 4.
    Holzberg M, Walker HK. Terry’s nails: revised definition and new correlations. Lancet. 1984;1:896–99.CrossRefPubMedGoogle Scholar
  5. 5.
    Park KY, Kim SW, Cho JS. Research on the frequency of terry’s nail in the medical inpatients with chronic illnesses. Korean J Dermatol. 1992; 30: 864–70.Google Scholar

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Nick Nelson
    • 1
  • Kweku Hayfron
    • 2
  • Alejandro Diaz
    • 1
  • Scott Lynch
    • 1
  • Irene Yen
    • 3
  • Allison Bakamjian
    • 4
  • Indhu Subramanian
    • 1
  1. 1.Wing A2 Department of Medicine AnnexHighland HospitalOaklandUSA
  2. 2.Sutter Health/Palo Alto Medical FoundationDublinUSA
  3. 3.Highland Hospital, UC San FranciscoSan FranciscoUSA
  4. 4.Highland Hospital, UC BerkeleyBerkeleyUSA

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