Terry's Nails Patient of about 70 years, HIV positive, transplanted kidney donor cadaver in the previous 6 months, complicated with urinary infections so he received multiple antibiotic therapy schemes. During prolonged hospitalization due to diarrhea due to Clostridium difficile . On physical examination, Terry's nails are seen (see image), in addition to signs of malnutrition. Laboratory with hypoalbuminemia. In patients with Terry's nails, the proximal two-thirds of the nail plate appear white, while the distal third is red. In his original publication in Lancet in 1954 , Richard Terry described "white nails" in 82 patients (out of a total of 100 studied) with liver cirrhosis. In his article, Terry suggested that this finding would probably be explained by an abnormal steroid metabolism since other manifestations also present in patients with cirrhosis (gynecomastia, palmar erythema, spider angiomas and skin stretch marks) were explained by this mechanism. It is currently believed that this finding is secondary to hypoalbuminemia. However, Terry's nails are not specific to cirrhosis since they can be seen in other entities associated with hypoalbuminemia (such as nephrotic syndrome). They can also be seen in patients with renal failure, diabetes and heart failure. #Terrys #Nails #Fingernails #Hands #PhysicalExam #Clinical #Photo
