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Nail symptoms Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Nail symptoms. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you noticed problems with your nails?
  2. What particular nail symptoms do you have?

    Why: e.g. discoloration, pale nails, brittle nails, nail bed infections, thickening of the nails, spoon shaped, clubbing of the nails, separation of nail from nail bed, pitting of the nails, lengthwise ridges - Changes in the nails can prove very helpful in diagnosis of systemic disease.

  3. Are the abnormalities focal (localized) or diffuse (widespread)?

    Why: Focal abnormalities include thickening (which is often due to fungal infections), inflammation (usually due to paronychia, onychia, fungal infection or syphilis), hemorrhages under the nail (due to trauma, subacute bacterial endocarditis or trichinosis), pitting of the nail (may be due to psoriasis) and atrophy of the nail (which may be due to peripheral vascular disease, epidermolysis bullosa, nail biting or peripheral neuropathy. Diffuse abnormalities of the nail may include thickening of the nails (due to syphilis, hyperthyroidism, hypothyroidism, clubbing, cyanotic heart disease, bronchiectasis, lung cancer), yellow nails (due to lymphoma or chest conditions) or spoon nails (due to iron deficiency anemia).

  4. Risk factors for fungal nail infection?

    Why: e.g. wearing of occlusive footwear, overcrowding of toes, communal bathing areas, poor peripheral blood circulation.

  5. Risk factors for iron deficiency anemia?

    Why: e.g. heavy periods, pregnancy, vegetarianism, peptic ulcer, gastrointestinal bleeding, celiac disease and frequent blood donations.

  6. Risk factors for ingrown nails?

    Why: e.g. injury or deformity to nail bed, faulty nail trimming, constricting shoes and poor hygiene.

  7. Past medical history?

    Why: e.g. clubbing of the nails may be due to cyanotic congenital heart disease, bronchiectasis, cystic fibrosis, Crohn's disease, Ulcerative colitis, Celiac disease, lung cancer, lung abscess, asbestosis, liver cirrhosis and thyrotoxicosis; HIV infection may increase the risk of fungal nail infections; psoriasis; Yellow nail syndrome may be associated with bronchiectasis, pleural effusion, Hodgkin's lymphoma, uterine cancer, malignant melanoma or lymphoma; systemic lupus erythematosus may cause inflammation of the nail folds; chronic renal failure and cirrhosis may cause "half and half" nails with the proximal part of the nail white to pink and the distal half of the nail red to brown.

  8. Medications?

    Why: e.g. blue nails may be caused by antimalarial medications, minocycline; chemotherapy may cause transverse opaque bands or a single transverse white band on the nails.

  9. If blue nails and blue tongue, is there a history of drug ingestion?

    Why: e.g. potassium chlorate, sulfanilamide and coal tar may cause hemoglobin abnormalities and thus central cyanosis.

  10. Possible poisoning?

    Why: e.g. carbon monoxide poisoning may cause cherry-red nails; arsenic poisoning may cause a single transverse white band across the nail.

  11. Occupational or other exposure to asbestos?

    Why: may indicate asbestosis or pleural mesothelioma as cause of clubbing.

  12. Family history?

    Why: e.g. cystic fibrosis, cyanotic congenital heart disease, thyroid disorders, celiac disease, Crohn's disease, Ulcerative colitis; psoriasis; Wilson's disease; hemochromatosis.

  13. Cigarette smoking

    Why: now and in the past? - increases the risk of lung cancer and increases the severity of asbestosis which may both cause finger clubbing.

  14. Intravenous drug abuse?

    Why: increases risk of subacute endocarditis which can cause finger clubbing; HIV increases the risk of fungal nail infections.

  15. Blue nails?

    Why: may suggest cyanosis, Wilson's disease, ochronosis, hemochromatosis or ingestion of certain medications.

  16. Red nails?

    Why: may suggest polycythaemia and carbon monoxide poisoning.

  17. Yellow nails? -many suggest Yellow nail syndrome. Nails are thickened with a diffuse yellow to green color with separation of the distal nail plate from the nail bed. May be due to lymphedema, pleural effusion (collection of fluid around the lung), bronchiectasis, Hodgkin's lymphoma, uterine cancer, malignant melanoma or lymphoma
  18. White nails?

    Why: may suggest hypoalbuminaemia (reduced albumin in blood) which may be due to chronic liver disease, severe malnutrition, nephrotic syndrome, protein losing gut disease.

  19. Nail and finger clubbing?

    Why: e.g. a loss of the angle between the nail bed and the finger. A subtle sign may be an increased in sponginess of the proximal nail bed. May be associated with cyanotic congenital heart disease, bronchiectasis, cystic fibrosis, Crohn's disease, Ulcerative colitis, Celiac disease, lung cancer, lung abscess, asbestosis, liver cirrhosis and thyrotoxicosis.

  20. Nail thickening?

    Why: diffuse thickening may result from syphilis, hyperthyroidism or hypothyroidism. Focal thickening may be due to fungal infection.

  21. Hemorrhages under the nail?

    Why: may be due to trauma, subacute bacterial endocarditism, scurvy or trichinosis.

  22. Pale nails?

    Why: due to anemia.

  23. Nail pitting?

    Why: may be due to psoriasis.

  24. Redness around the nails

    Why: (i.e. inflammation of the nail fold)? - may suggest paronychia, onychia fungal infection, systemic lupus erythematosus or syphilis.

  25. Wasting (atrophy) of nails?

    Why: may suggest peripheral vascular disease, peripheral neuropathy, epidermolysis bullosa or nail biting).

  26. Spoon nails?

    Why: due to iron deficiency anemia.

  27. Onycholysis (lifting up of the nail bed and loosening of the nails)?

    Why: may be due to hyperthyroidism or psoriasis.

  28. Non-pigmented transverse lines (Beau's lines)?

    Why: due to fever, significant weight loss due to chronic disease, malnutrition.

  29. Blueness of the tongue or lips?

    Why: If associated with finger clubbing determines presence of cyanosis and thus may suggest cyanotic congenital heart disease and pulmonary arteriovenous aneurysms. If associated with blue nails, may indicate hemoglobin abnormalities or cyanosis e.g. chronic obstructive pulmonary disease.

  30. Cough or shortness of breath?

    Why: if associated with finger clubbing may suggest a lung condition such as bronchiectasis, chronic interstitial fibrosis, asbestosis, emphysema, lung cancer, lung abscess, cystic fibrosis or tuberculosis. If associated with yellow nails may suggest pleural effusion (collection of fluid around the lung) or bronchiectasis.

  31. Fever?

    Why: if associated with finger clubbing may suggest empyema (pus in the cavity enclosing the lungs), lung abscess, tuberculosis, subacute bacterial endocarditis. Fever itself may cause non-pigmented transverse lines on the nail.

  32. Symptoms of hyperthyroidism?

    Why: may cause finger clubbing and lifting of the nail bed e.g. intolerance to heat, tremor, agitation, weight loss, increased appetite.

  33. Symptoms of fungal nail infection?

    Why: e.g. nail becomes thickened, cracked, crumbly and raised by underlying debris in the nail bed.

  34. Symptoms of Candida nail infection?

    Why: e.g. similar to fungal nail infection except nail folds are swollen, red, painful and tender.

  35. Symptoms of nails affected by psoriasis?

    Why: e.g. nail pitting, nail thickening, lifting of the nail from nail bed, yellow-brown spots under the nail plate, may be associated with psoriasis skin rash and painful joints.

  36. Symptoms of methemoglobinemia?

    Why: e.g. blue tongue and lips, blue nails.

  37. Symptoms of iron deficiency anemia?

    Why: e.g. widespread spoon-shaped nails, brittle nails, pallor of skin and conjunctiva, tiredness.

Conditions listing medical symptoms: Nail symptoms:

The following list of conditions have 'Nail symptoms' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Nail symptoms or choose View All.

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Conditions listing medical complications: Nail symptoms:

The following list of medical conditions have 'Nail symptoms' or similar listed as a medical complication in our database.

 

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