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Nail abnormality

  • Common ddx

    • paronychia, ingrown nail, herpetic whitlow
    • trauma, nail biting
    • onychomycosis, hyperkeratosis
    • finger clubbing, koilonychia/iron deficiency
    • psoriasis
  • Serious ddx

    • endocarditis
    • clubbing due to malignancy
    • nail tumor
    • melanoma
  • Labs

    • CBC if suspect anemia
    • blood culture, echo if suspect endocarditis
    • derm consult RE biopsy nail if suspect nail tumor
  • Pain ddx

    • paronychia, ingrown nail, herpetic whitlow, nail trauma
  • Discoloration ddx

    • Leukonychia, Onycholysis, melanonychia, splinter hemorrhage, nail trauma, Onychomycosis, endocarditis, melanoma, green nail syndrome
  • Thick nail ddx

    • nail hyperkeratosis, Onychomycosis, finger clubbing
  • Rough nail ddx

    • Trachyonychia, nail hyperkeratosis, Onychomycosis, nail tumor
  • Nail pitting ddx

    • psoriasis, alopecia areata
  • Nail spliting ddx

    • onychorrhexis, onychoschizia, nail tumor, nail trauma
  • Nail groove ddx

    • beau line, onychomadesis, vertical nail ridges

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.