What Are Your Nails Telling Your Rheumatologist or Gastroenterologist?
Got a great question from Not That Kind of Chronic (whose sense of humor in blog naming I quite enjoy)
Your recent post mentioned not to wear nail polish to a rheumatologist. I always have a manicure. Can you tell me what my nails might show?
The first time you see one, yes. It’s not absolutely necessary to remove your polish, but the condition of your nails can tell your rheumatologist about the state of your health, and many doctors will examine both your fingernails and toenails.
I, like many other rheum ladies, pretty much always have a manicure. I don’t take off my polish unless I notice there is a new nail development, but I do remove it when I see a new relevant specialist for the first time.
It’s particularly important if you are seeking a diagnosis from a rheumatologist, gastroenterologist, or other specialist for a systemic disease!
- Nail Pitting — can be indicative of psoriasis (important for patients with Psoriatic Arthritis), Reactive Arthritis, and other connective tissue diseases
- Spoon Nails (Koilonychia)— can be indicative of Systemic Lupus, Raynaud’s, and anemia
- Yellow Nail Syndrome — occurs in Rheumatoid Arthritis patients or often the result of infection or medications, both of which are relevant to Autoimmune Arthritis patients.
- Splinter Hemorrhages— small blood clots under the nail can indicate Systemic Lupus, Rheumatoid Arthritis, Antiphospholipid Syndrome, Psoriasis, Vasculitis, and Scleroderma (all rheumatology-related).
- Nail Clubbing— can occur with Inflammatory Bowel Disease (e.g., Crohn’s, Ulcerative Colitis), liver disease, and pulmonary diseases.
- Both Discoid and Systemic Lupus can cause nail changes such as cracking, curling, and even complete loss of nails.
- Rheumatoid Vasculitis or Nail Fold Vasculitis— can cause pitting, sores, redness, and infarcts of the nail-bed (not a pretty picture).
- Nail health can also reveal possible vitamin deficiencies and malnutrition, both important when treating rheumatological diseases.
Some food for thought before your visit to a new specialist!
Just for fun, what do you use on your peeling nails? Do you keep yours painted? How do you take care of your nails? Answer below in the answer or Disqus box!