Have you ever glanced at your nails and noticed an unexpected change in their shape? Or perhaps you would have seen someone’s fingertips with an unusual appearance? Nail clubbing is not something to brush aside. Because it would be a sign of our underlying health issues. In fact, it’s estimated that up to 50% of people with lung cancer have nail clubbing.
The confusion regarding nail clubbing is completely understandable. As a hand surgeon, I have personally witnessed individuals suffering from this condition and it’s a condition, and let me tell you, it’s a matter that demands serious medical attention. This made me write the article, aiming to provide you with a clearer insight into understanding the treatments for nail clubbing, particularly focusing on nail clubbing in the context of hands. But that’s not all, we’ll also delve into the related aspects of the condition, such as :
- What is clubbing of nails and its causes?
- Nail clubbing stages
- What lung disease causes finger clubbing?
- What is the first stage of nail clubbing? And more
So without further ado let’s dive right in
What is nail clubbing? and how it looks like
If an individual is suffering from nail clubbing, they may observe the change in the appearance of the fingernails or toenails as they become enlarged and bulged. The nails become curved and have a ridged appearance.
When the condition presents itself, you might find that your nails may feel soft, look red, or even feel warm to the touch. In some instances, the fingertips might even appear more rounded than usual.
Usually, the disease starts by affecting your forefinger or thumb before spreading to other fingers.
What causes nail clubbing?
Nail clubbing or finger clubbing serves as an indication of the underlying health condition of your body. The exact cause of nail clubbing is unknown. But certain conditions are caused by a disruption in blood circulation to these areas, often linked to significant health conditions such as:
Lung diseases: Lung diseases like lung cancer, cystic fibrosis, a genetic condition that creates a thick secretion within the lungs and other organs or interstitial lung disease can be a reason for the condition
Heart disease: Congenital heart defects or cyanotic heart diseases could lead to nail clubbing.
Liver disease: Liver cirrhosis or hepatitis could contribute to the bulging of your fingertips
Inflammatory bowel diseases: Diseases like Crohn’s disease and ulcerative colitis can also lead to the clubbing of your finger or toenails.
In addition to that, the condition can be also the byproduct of thyroid disease, AIDS, or a type of cancer like Hodgkin’s lymphoma – cancer that affects the lymphatic system.
As you can see, the exact cause of the condition remains a mystery, yet nail clubbing serves as a warning sign given by our body to take immediate action as there is something bad happening within us.
How is nail clubbing diagnosed?
Nail clubbing is usually identified by a doctor by physical examination and asking about the family history of the health condition. The doctor will look at the shape of the shape and appearance of the fingernails. One common test in the physical examination is the Schhamroth window test.
During the test, your two opposing fingers from both arms are placed back with the nails of the two fingers touching each other. Normally, a diamond-shaped space appears between the nail beds of the two fingers
However, If this space is missing then it could be due to clubbed fingers or clubbed nails.
In some cases, the doctor may order a blood test or imaging test to rule out other possible causes.
Also based on the symptoms your doctor may suggest a chest X-ray and possibly a CT scan to check whether the person has a heart-related or lung-related disease.
What are the different stages of nail clubbing?
Subclinical stage: Here there is no visible changes can be noticed in the fingertips. But there will be a softening of the nail bed and an increase of blood flow to the fingertips.
Clinical stage: Here the fingernails start to show visible changes. The fingertips started to form a rounded shape, thicker, and the nails became curved in shape. Sometimes they even become red.
Advanced stage: The final stage where the changes to the nails are pronounced. Here the thickening of the fingernails is at an extreme level. There may be other symptoms like increased nail growth and changes in the skin around the nails.
What does the initial stage of nail clubbing look like?
Clubbing usually develops around the thump or forefinger before spreading to the remaining fingers of the hand. Floating nail signs and profile signs are usually seen as the early clubbing characteristics.
A floating nail causes when the base of your nail gets separated from the bone and when you touch the nail you feel like the nail is floating without any connection. Your nails may feel soft.
Lovibond angle sign: From the side, your fingernail should have a little dent at its base. As your nail grows towards your fingertip, this dent, known as the Lovibond angle, makes a little upward curve. But in the early stages of nail clubbing your nail and nail bed seem flat from the side.
What lung disease causes finger clubbing?
Some of the lung conditions that contribute include:
- Lung cancer: which causes the lung cells to grow out of control
- Cystic fibrosis: This usually affects the cells that produce fluids like mucus and sweat and causes them to thicken and sticky. Later it accumulates in the lungs or wind passages
- Pulmonary fibrosis: A condition that causes the lungs to scar ( thickening of tissue), making it harder to breathe.
- Bronchiectasis: The bronchial tubes of the lungs are permanently damaged causing the bacteria and mucus to build up and pool in the lungs.
With that being discussed now let’s look at the core topic of discussion
Treatment for nail clubbing:
The treatment prescribed by the doctor depends on the diagnosis of the underlying condition responsible for the nail clubbing. As you’re aware, clubbing can arise from issues related to the lungs or heart. Your doctor may typically suggest:
- A combination of chemotherapy or radiation therapy and sometimes surgery to cure cancer if the Cancer is the underlying condition.
- If diagnosed with some heart defect or problem, your doctor may suggest surgery to correct it as it could be the reason for irregular blood flow that caused clubbing.
- Medications may be prescribed to treat the underlying heart or lung condition.
- Lifestyle changes for better health like quitting smoking or eating a healthy diet can help improve the underlying health condition.
How to prevent nail clubbing?
As of now, there is no accurate way to prevent nail clubbing, but maintaining a healthy lifestyle will help you keep some serious health conditions at bay.
If you smoke, it is better to quit it as it can lead to heart disease which could be a reason for nail clubbing.
If you are an aged person it’s better to get a regular medical checkup to keep your health in check.
Also, it’s always important to maintain personal hygiene like keeping your nails properly trimmed this can prevent the nails from overgrowing and causing infection.
I hope by now you have a better understanding of nail clubbing and the underlying conditions contributing to it. We’ve gone through various dimensions of the disease starting from its causes, all the way to its preventive measures.
Nail clubbing itself might not be a serious issue but it will be a signal that our body sends to remind us that something is bad happening within us. Thus it’s crucial to listen to our bodies and take timely medical attention.
Armed with insights, you’re equipped to approach your health with confidence, making informed choices that pave the way for a healthier and more vibrant future.