Terry's nail (TN) might be causally associated with cirrhosis or other disorders, but his criteria have been proved to be inadequate reflection of systemic disorders.
Modified criteria of Holzberg and Walker were introduced in TN examination in 1984. Using these criteria, fingernails were studied in 444 medical inpatients with chronic systemic diseases at Taegu Catholic Hospital from March 1991 to March 1992.
There were 136 (30.6%) patients with TN and 308 (69.4%) patients without TN, respectively. Ninety-three patients with TN showed a significant association with cirrosis (49/86, 57%, p<0.01 by the X2-test), congestive heart failure (18/35, 51%,
p<0.05),
and diabetes mellitus (25/51, 49%, p<0.05), and otherwise not significantly associated with chronic renal failure (19%), and cancer (18%). Male and female patients with TN were affected about equally.
Age distribution in the patients with TN showed 35 (25.8%) in the age group from twenty to forty-nine and 101 (74.2%) in the age group from fifty and above, with a mean age of 57.3±14.0, whereas the patients without TN had 178 (57.8%) and 130
(42.2%),
with 47.4±16.9, respectively. The greater part was distributed in the older group (P<0.001) by student ttest), suggestive of an increased risk in older group.
The average number of nails affected per patient was 7.6, tending to be higher in frequency close to the thumb, with an equal frequency in sex. Thirty-nine patients (28.7%) had all nails affected. The distal band width was 0.5 to 3.0mm averaging
1.0±0.5mm with no difference in sex. The distal band was pink in 43 (31.6%) of the 136 patients with TN, brown in 62 (45.6%) and intermediate in 13 (22.8%).
The results of routine laboratory test such as hemogram, erythrocyte sedimenation rate, liver enzyme, triglyceride, protein, albumin, blood urea nitrogen and creatinine were statistically insignificant between the patients with and without TN.
(Kor J Dermatol 1992;30(6):864-870)
|