Terry's nails

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Terry's nails
Terry's nails
SymptomsWhite nail[1]
CausesLiver failure, cirrhosis, diabetes mellitus, congestive heart failure,[2] normal ageing[3]
Diagnostic methodPhysical examination
Differential diagnosisHalf and half nail, Muehrcke's nails[3]
TreatmentDirected at underlying condition
Frequency25% of hospital admissions[2]

Terry's nails are are a type of chromonychia of the white nail variety.[1][3] The characteristic "ground glass" appearance occurs without any lunula, accompanied by a normal pink band near the tip.[3] All the nails are typically affected equally.[4]

It typically occurs in liver failure, cirrhosis and diabetes.[5]

It is due to a defect in the nail bed; a decrease in vascularity and an increase in connective tissue within the nail bed.[5] It also occurs in congestive heart failure and chronic kidney disease.[3] It can be part of normal ageing.[3]

Diagnosis is by appearance, but it may appear similar to Half and half nail and Muehrcke's nails.[3]

The condition has been reported in around 25% of people admitted to hospital.[2] 80% of those with severe liver disease have Terry's nails.[6]

This finding was named for Richard Terry.[7]

Signs and symptoms

See also


  1. 1.0 1.1 Starace, Michela; Alessandrini, Aurora; Piraccini, Bianca Maria (2019). "11. Chromonychia". In Singal, Archana; Neema, Shekhar; Kumar, Piyush (eds.). Nail Disorders: A Comprehensive Approach. Boca Raton: Taylor & Francis. pp. 119–129. ISBN 978-0-8153-7834-1. Archived from the original on 2023-06-30. Retrieved 2023-06-02.
  2. 2.0 2.1 2.2 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "33. Diseases of the skin appendages". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 784. ISBN 978-0-323-54753-6. Archived from the original on 2023-07-01. Retrieved 2024-01-23.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Witkowska, Anna B; Jasterzbski, Thomas J; Schwartz, Robert A (2017). "Terry's Nails: A Sign of Systemic Disease". Indian Journal of Dermatology. 62 (3): 309–311. doi:10.4103/ijd.IJD_98_17. ISSN 0019-5154. PMID 28584375. Archived from the original on 2021-10-18. Retrieved 2022-04-14.
  4. Saavedra, Arturo; Roh, Ellen K.; Mikailov, Anar (2023). "32.Disorders of the nail apparatus". Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology (9th ed.). New York: McGraw Hill Professional. pp. 849–872. ISBN 978-1-264-27801-5. Archived from the original on 2023-12-31. Retrieved 2024-01-18.
  5. 5.0 5.1 Johnstone, Ronald B. (2017). "2. Diagnostic clues and "need-to-know" items". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 32. ISBN 978-0-7020-6830-0. Archived from the original on 2021-05-25. Retrieved 2022-04-14.
  6. Nia, AM; Ederer, S; Dahlem, KM; Gassanov, N; Er, F (July 2011). "Terry's nails: a window to systemic diseases". The American Journal of Medicine. 124 (7): 602–4. doi:10.1016/j.amjmed.2010.11.033. PMID 21683827.
  7. Terry, Richard (10 April 1954). "White nails in hepatic cirrhosis". Lancet. 266 (6815): 757–9. doi:10.1016/s0140-6736(54)92717-8. PMID 13153107.