Generalized Discolorations of the Nail Plate
Nail discoloration is a useful method for identifying potential problems.
White nails can be caused by anemia, edema, or vascular conditions (Figure 24). Consider the following:
Figure 24. Example of white nails.
Pink or Red Nails
With pink or red nail discoloration, the following should be considered (Figure 25):
Carbon monoxide (cherry red);
Figure 25. Example of pink and red nails.
Brown-gray nails may suggest the following (Figure 26):
Vitamin B12 deficiency;
Topical agents, including hair dyes, solvents for false nails, varnish, and formaldehyde (among many others)
Figure 26. Example of brown-gray nails.
Yellow nails suggest the following (Figure 27):
Consider yellow nail syndrome if a patient has lymphedema and bronchiectasis.
Figure 27. Example of yellow nails. Image courtesy of www.dermnet.com Used with permission.
Green or Black Nails
Green or black nails indicate the following (Figure 28):
Chronic Pseudomonas spp infection; and
Figure 28. Example of black nails.
Medscape Family Medicine © 2009
Cite this: Mark E. Williams. Examining the Fingernails When Evaluating Presenting Symptoms in Elderly Patients - Medscape - Nov 23, 2009.