Patterns of nail changes in chronic liver diseases

Background: Nail abnormalities were frequently associated with liver diseases. Early detection of these nail changes may help to initiate early treatment and reduce serious complications, sequelae, morbidity, and mortality of chronic liver diseases.
Objective: To record the frequency and patterns of nail changes in patients with chronic liver diseases.
Patients and methods: The study included 1000 patients who attended the Tropical Medicine and Gastroenterology department in Sohag University Hospital,  between October 2017 and October 2018 with clinical and/ or laboratory diagnosis of liver diseases. A full nail examination was performed.
Results: In this study,  nail changes are found in the majority of patients with liver diseases (80.5% ). White nails were the commonest abnormality noted followed by longitudinal striations, terry's nails, brittle nails, clubbing, flat nails, and onychomycosis.
Conclusion: Nail abnormalities are common with liver cirrhosis as well as with HCV and HBV infections. The cause of these changes remains unknown; it may be as a consequence of decreased cell-mediated immunity, immunosuppression, iron deficiency, anemia or old age, but not that of the virus itself. It is important for the clinicians to understand and examine carefully the nails for color, texture, thickness, and curvature to reach a prompt and early diagnosis of patients with liver disease.