Nail clubbing is a clinically descriptive term characterized by bulbous swelling of the soft tissue of the terminal phalanx of a digit with subsequent loss of the normal angle between the nail and the nail bed (as in the picture). This condition may be symmetric bilaterally, it may be unilateral, or it may involve a single digit.

When nail clubbing runs in families we call it primary, but there are also cases of secondary clubbing with multiple causes such as:

  • Pulmonary diseases: Lung cancer, cystic fibrosis, interstitial lung disease, idiopathic pulmonary fibrosis, sarcoidosis, empyema, and pleural mesothelioma
  • Cardiac diseases: Cyanotic congenital heart disease and bacterial endocarditis
  • Gastrointestinal diseases: Ulcerative colitis, Crohn’s disease, primary biliary cirrhosis, cirrhosis of the liver, and achalasia
  • Malignancies: Thyroid cancer, thymus cancer, and Hodgkins disease
  • Miscellaneous conditions: Acromegaly, pregnancy, and sickle cell disease

Nail clubbing can indicate an underlying disease, and it needs medical consultation to exclude any malignancy.

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Resources:

Medscape

Image source: Wikipedia.

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