Fast Five Quiz: Fingernail and Toenail Conditions

William James, MD


February 07, 2020

Clubbing can be idiopathic or secondary to many underlying pathologies in various organ systems. Causes of idiopathic or primary clubbing include pachydermoperiostosis, familial clubbing, and hypertrophic osteoarthropathy. Causes of secondary clubbing include:

  • Pulmonary disease: Lung cancer, cystic fibrosis, interstitial lung disease, idiopathic pulmonary fibrosis, sarcoidosis, lipoid pneumonia, empyema, pleural mesothelioma, pulmonary artery sarcoma, lung hydatid cysts, and pulmonary metastases

  • Cardiac disease: Cyanotic congenital heart disease, other causes of right-to-left shunting, and bacterial endocarditis

  • Gastrointestinal disease: Ulcerative colitis, Crohn disease, primary biliary cirrhosis, cirrhosis of the liver, hepatopulmonary syndrome, leiomyoma of the esophagus, achalasia, and peptic ulceration of the esophagus

  • Skin disease: Pachydermoperiostosis, Bureau-Barrière-Thomas syndrome, Fischer syndrome, palmoplantar keratoderma, and Volavsek syndrome

  • Malignancies: Thyroid cancer, thymus cancer, Hodgkin disease, and disseminated chronic myeloid leukemia

  • Miscellaneous conditions: Acromegaly, thyroid acropachy, pregnancy, an unusual complication of severe secondary hyperparathyroidism, sickle cell disease, and hypoxemia

Read more about clubbing of the nails.


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