Trophic Implications of Altered Body Composition Observed in or Near the Nails of Hemodialysis Patients

Nail dystrophy?a clinical sign of malnutrition in the disabled child

“…The medications our patient received are not reported to cause Beau lines. Iron depletion can cause other trophic manifestations in nails such as koilonychia (spoon nails) and onycholyisis, but the characteristics of these nails were different [2]. There were no severe febrile illnesses that could account for nail dystrophy in this case.…”

A case of Leukonychia with scanning electron microscope observation

“…It may be acquired or inherited. Acquired leukonychia is frequently associated with trauma (Baran and Perrin, '95; Bowling et al ., 2004), chemotherapeutic drugs (Yoruk and Yukselgungor, 2003), local or systemic infections (Mautner et al ., 2000), hypocalcaemia (Foti et al ., 2004), zinc deficiency (Kelly et al ., '98), heavy metal poisoning (Mees, '19; Assadi, 2005), and systemic disease (Jarek et al ., '96). Inherited leukonychia can be an isolated condition (De and Handa, 2007) or one of several inherited leukonychia syndromes (Bart and Pumphrey, '67; Bushkell and Gorlin, '75).…”

Koilonychia: an update on pathophysiology, differential diagnosis and clinical relevance

“… Petrol, solvents, engine oils (mechanics, cabinet‐makers, homemakers, railway workers, oil‐burner repairers) Acids, alkalis (cement workers/ brick‐layers), thioglycolate (hairdressers), sulphur and arsenic (chemical hair removal products) Mechanical trauma (rickshaw boys, butchers, mushroom growers, coil winders, slaughterhouse workers, pin threaders) Thermal burns Nail biting, thumb/finger sucking, poorly fitting shoes High altitude ‘Ladakhi koilonychia’ Avitaminosis/Nutritional Nutrients Protein deficiency/low albumin Vitamin C Vitamin B12 Niacin, zinc, copper Sulphur‐containing amino acids: methionine, cystine Populations Kidney transplantation, End stage renal disease Alcoholism Poor nutrition, cachexia Post‐gastrectomy …”

“…Koilonychia may occur in patients with poor nutrition due to deficiencies in Vitamin C, zinc, copper, selenium, cysteine and other amino acids . Recent investigations on these associations are lacking.…”