THIS common nail condition could be a red flag for liver cirrhosis

To our surprise, nails can reveal a lot about our overall health. They might be a silent indicator at first, but they message us about numerous serious conditions. One such condition is known as Terry nails, which might seem like a simple change, but it could be a warning sign of liver cirrhosis. Understanding this connection can help us detect liver problems early and potentially save lives.Terry’s nails are a distinct nail abnormality characterised by a white, “frosted” appearance that covers most of the nail bed, leaving only a narrow pink or brown band at the tip. This condition was first discovered by Dr. Richard Terry in 1954. This condition is not just a cosmetic concern; it is associated with serious underlying health issues. Most notably, liver cirrhosis, but they may also appear in individuals with heart failure, diabetes, or kidney disease. Recognising this subtle change in nail appearance could offer important clues about a person’s internal health.Born on October 19, 1914, Dr. Richard Terry was a distinguished British physician whose career left a lasting legacy and impact in the field of internal medicine. During World War II, Dr. Terry served as a regimental and field ambulance medical officer in the Royal Army Medical Corps (Territorial Army). He achieved a lot during his long life, but when life finally decided to congratulate him on making such inventions in medical science, he passed away on his 46th birthday. Despite his early death, his contributions endure, particularly his identification of the nail condition, called Terry’s nails.In the words of Dr. Richard Terry, ‘fully developed white nails exhibit a ground-glass-like opacity of almost the entire nail bed’ are called Terry’s nails. It extends from the base of the nail, where the lunula is indistinguishable, to within one or two millimetres of the distal border of the nail bed, leaving a distal zone of normal pink. The condition is bilaterally symmetrical, with a tendency to be more marked in the thumb and forefinger.Dr. Richard Terry investigated this nail-bed abnormality in 82 of 100 consecutive patients with hepatic cirrhosis. In more than 90% of those patients, the cirrhosis was due to alcohol abuse. Six months later, Terry observed such red half-moons also in patients with congestive heart failure.A research titled “Association of Terry’s nails with Liver Cirrhosis” evaluated 1,000 consecutive patients from hepatology and gastroenterology clinics across two institutions, assessed between May 2016 and February 2020, among these 117 patients had Terry’s nails.Among patients diagnosed with Liver cirrhosis, 25.6% had Terry’s nails. After other factors such as age, heart failure, type 2 diabetes, and chronic liver disease, such as cirrhosis, remained the only significant correlate with an odds ratio of 5.7 (almost 95%).In clinical implications, Terry’s nails can serve as a supportive, not definitive, clinical condition of cirrhosis, especially in primary care.