Hyperthyroid nails
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Hyperthyroid Nails: Understanding Onycholysis and Other Nail Changes
Introduction to Hyperthyroid Nails
Hyperthyroidism, a condition characterized by excessive thyroid hormone production, can manifest in various physical symptoms, including distinct changes in the nails. These nail changes can serve as early indicators of thyroid dysfunction, aiding in timely diagnosis and management.
Onycholysis in Hyperthyroidism
Onycholysis, also known as Plummer's nails, is a common nail disorder associated with hyperthyroidism. It involves the separation of the distal nail body from the nail bed, often resulting in a concave appearance and trapping of dirt under the nail, giving it a dark look . This condition was first described by Henry Stanley Plummer in 1918 and is frequently observed in patients with Graves' disease, a common cause of hyperthyroidism .
Prevalence and Specificity
Onycholysis is not exclusive to hyperthyroidism but is a significant indicator. Studies have reported a 5.2% prevalence of onycholysis in hyperthyroid patients. While it is a notable sign, it can also occur in other conditions such as psoriatic arthritis, lung cancer, and trauma, making differential diagnosis essential .
Other Nail Changes in Hyperthyroidism
In addition to onycholysis, hyperthyroidism can lead to other nail abnormalities. Koilonychia, or spoon-shaped nails, and brittle nails are also associated with this thyroid condition . These changes result from the rapid growth and altered metabolism of the nail matrix due to excessive thyroid hormones.
Diagnostic Importance
The presence of onycholysis and other nail changes can be crucial for early diagnosis of hyperthyroidism. Dermatologists and clinicians should consider thyroid function tests when encountering unexplained nail disorders, especially onycholysis . This approach can lead to the identification of asymptomatic hyperthyroidism, allowing for prompt treatment and management.
Conclusion
Nail changes, particularly onycholysis, are significant indicators of hyperthyroidism. Recognizing these signs can facilitate early diagnosis and treatment, improving patient outcomes. Clinicians should remain vigilant for these nail abnormalities and consider thyroid function evaluation in their presence.
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