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Eating Disorders and the Nails

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Abstract

The structure of human nails is altered by malnutrition. This impacts the nail’s physical characteristics. Patients who suffer from anorexia nervosa and bulimia nervosa are at increased risk for development of abnormal nails from both the dietary deficiency and compulsive actions associated with the eating disorder. Physical exam findings include linear patterns on the nail plate, such as those seen in Beau’s lines, Terry’s nails, and Muehrcke’s lines, as well as color changes seen in B12 deficiency and splinter hemorrhages. Nutrition is essential for the development of healthy nails, and nutrient deficiencies may lead to brittleness or koilonychia of the nail plate. Abuse of medications, such as anorectics, diuretics, and laxatives, produces nail changes that include digital clubbing. Those with eating disorders may also have onychophagia or onychotillomania as all are on the obsessive-compulsive spectrum. Successful nail treatment in patients with eating disorders is dependent on treating the eating disorder.

Keywords

  • Anorexia Nervosa
  • Eating Disorder
  • Idiopathic Pulmonary Fibrosis
  • Bulimia Nervosa
  • Nail Plate

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Beau JHS (1846) Note sur certains caracteres de semeiologie retrospective presents par les ongles. Arch Gen Med 11:447

    Google Scholar 

  2. Weismann K (1977) Lines of Beau: possible markers of zinc deficiency. Acta Derm Venereol 57:88

    PubMed  CAS  Google Scholar 

  3. Walter JF (1979) Scurvy resulting from a self-imposed diet. West J Med 130:177–179

    PubMed  CAS  Google Scholar 

  4. Nia AM, Ederer S, Dahlem KM, Gassanov N, Er F (2011) Terry’s nails: a window to systemic diseases. Am J Med 124:602–604

    PubMed  CrossRef  Google Scholar 

  5. Terry R (1954) White nails in hepatic cirrhosis. Lancet 10:757–759

    CrossRef  Google Scholar 

  6. Muehrcke RC (1956) The finger-nails in chronic hypoalbumaemia. Br Med J 1:1327–1328

    PubMed  CrossRef  CAS  Google Scholar 

  7. Carmel R (1985) Hair and fingernail changes in acquired and congenital pernicious and anemia. Arch Intern Med 145:484–485

    PubMed  CrossRef  CAS  Google Scholar 

  8. Noppakun N, Swasdikul D (1986) Reversible hyperpigmentation of skin and nails with white hair due to vitamin B12 deficiency. Arch Dermatol 122:896–899

    PubMed  CrossRef  CAS  Google Scholar 

  9. Ridley CM (1977) Pigmentation of fingertips and nails in vitamin B12 deficiency. Br J Dermatol 97:105–106

    PubMed  CrossRef  CAS  Google Scholar 

  10. Gilliam J, Cox AJ (1973) Epidermal changes in vitamin B21 deficiency. Arch Dermatol 107:231–236

    PubMed  CrossRef  CAS  Google Scholar 

  11. Schulze UM, Pettke-Rank CV, Kreienkamp M, Hamm H, Brocker EB, Wewetzer C, Trott GE, Warnke A (1999) Dermatologic findings in anorexia and bulimia nervosa of childhood and adolescence. Pediatr Dermatol 16:90–94

    PubMed  CrossRef  CAS  Google Scholar 

  12. Gupta MA, Gupta AK, Haberman HF (1987) Dermatologic signs in anorexia nervosa and bulimia nervosa. Arch Dermatol 123:1386–1390

    PubMed  CrossRef  CAS  Google Scholar 

  13. Baran R, Dawber RP, Haneke E, Tosti A, Bristow I (2003) A text atlas of nail disorders: techniques in investigation and diagnosis, 3rd edn. Martin Dunitz, London

    Google Scholar 

  14. Tosti A, Baran R, Dawber RPR (2001) The nail in systemic diseases and drug-induced changes. In: Baran R, Dawber RPR, de Berker DAR, Haneke E, Tosti A (eds) Diseases of the nails and their management, 3rd edn. Blackwell Science, Oxford, pp 105–120

    Google Scholar 

  15. Miller S (1989) Nutritional deficiency and the skin. J Am Acad Dermatol 21:1–30

    PubMed  CrossRef  CAS  Google Scholar 

  16. Fadhil NN (2005) Re: Nutritional koilonychia in 32 Iraqi subjects. Ann Saudi Med 25:438–439

    PubMed  Google Scholar 

  17. Al-Dabbagh TQ, Al-Abachi KG (2005) Nutritional koilonychia in 32 Iraqi subjects. Ann Saudi Med 25:154–157

    PubMed  Google Scholar 

  18. Scheinfeld N, Dahdah MJ, Scher R (2007) Vitamins and minerals: their role in nail health and disease. J Drug Dermatol 6:783

    Google Scholar 

  19. Tyler I, Wiseman MC, Crawford RI, Birmingham CL (2002) Cutaneous manifestations of eating disorders. J Cutan Med Surg 6:345–353

    PubMed  CrossRef  Google Scholar 

  20. Litt JZ (2004) Litt’s drug eruption reference manual, 10th edn. Taylor & Francis Group, London

    Google Scholar 

  21. Rutherford T, Sinclair R (2007) Photo-onycholysis due to indapamide. Australas J Dermatol 48:35–36

    PubMed  CrossRef  Google Scholar 

  22. Pryor T, Wiederman MW, McGilley B (1996) Laxatie abuse among women with eating disorders: an indication of psychopathology? Int J Eat Disord 20:13–18

    PubMed  CrossRef  CAS  Google Scholar 

  23. Pines A, Olchovsky D, Bregman J, Kaplinsky N, Frankl O (1983) Finger clubbing associated with laxative abuse. South Med J 76:1071–1072

    PubMed  CrossRef  CAS  Google Scholar 

  24. Silk DBA, Gibson JA, Murray CRH (1975) Reversible finger clubbing in a case of purgative abuse. Gastroenterology 68:790

    PubMed  CAS  Google Scholar 

  25. Gatha R (2004) Cutaneous changes in chronic alcoholics. Indian J Dermatol Venereol Leprol 70:79–81

    Google Scholar 

  26. Lim AK, Hooke DH, Kerr PG (2008) Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust 188:121–122

    PubMed  Google Scholar 

  27. Malmquist J, Ericsson B, Hulten-Nosslin MB, Jeppsson JO, Ljungberg O (1980) Finger clubbing and aspartylglucosamine excretion in a laxative-abusing patient. Postgrad Med J 56:862–864

    PubMed  CrossRef  CAS  Google Scholar 

  28. Prior J, White I (1978) Tetany and clubbing in a patient who ingested large quantities of senna. Lancet 2:947

    PubMed  CrossRef  CAS  Google Scholar 

  29. Yaemsiri S, Hou N, Slining MM, He K (2010) Growth rate of human fingernails and toenails in healthy American young adults. J Eur Acad Dermatol Venereol 24:420–423

    PubMed  CrossRef  CAS  Google Scholar 

  30. Feteih RM (2006) Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi Arabian adolescents: a research report. Head Face Med 2:25

    PubMed  CrossRef  Google Scholar 

  31. Leung AKC, Robson LM (1990) Nailbiting. Clin Pediatr 29:690

    CrossRef  CAS  Google Scholar 

  32. Fuqua W, Brosh S (2006) Nail biting. In: Practitioner’s guide to evidence-based psychotherapy. Springer, New York

    Google Scholar 

  33. Hollander E (1996) Obsessive-compulsive disorder-related disorders: the role of selective serotonergic reuptake inhibitors. Int Clin Psychopharmacol 11:75–87

    PubMed  CrossRef  Google Scholar 

  34. Koritzky G, Yechiam E (2011) On the value of nonremovable reminders for behavior modification: an application to nail-biting (onychophagia). Behav Modif 35:511–530

    PubMed  CrossRef  Google Scholar 

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Correspondence to Antonella Tosti M.D. .

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Handler, M.Z., Tosti, A. (2013). Eating Disorders and the Nails. In: Strumia, R. (eds) Eating Disorders and the Skin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-29136-4_14

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  • DOI: https://doi.org/10.1007/978-3-642-29136-4_14

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