Blue nails

Azure Lunula
Blue nails due to minocycline
SpecialtyDermatology

Blue nails,a type of chromonychia, describes a blue discoloration of finger or toenails.[1][2] It generally refers to Azure lunulae, the blue nails seen in silver poisoning and cases of Wilson's disease.[3]

Blue nails may be normal in some black people, and can be associated with subungual hematoma, melanotic whitlow and blue naevus.[2] Nails may turn blue with some medications including 5-FU, minocycline, antimalarials, hydroxyurea, imipramine and azidothymidine.[2]

Signs and symptoms

  • Blue nails due to minocycline
    Blue nails due to minocycline
  • Blue nails due retigabine
    Blue nails due retigabine

Causes

The blue lunulae may be seen in argyria and cases of Wilson's disease, and has been reported in hemoglobin M disease and hereditary acrolabial telangiectases.[2] Medications that can cause nails to turn blue include 5-FU, minocycline, antimalarials, hydroxyurea, imipramine and azidothymidine.[2] Other conditions associated with blue nails include subungal hematoma, melanotic whitlow and blue naevus.[2]

In Wilson's disease the blue color involves the lunula (most intense pigmentation) and fades proximally. In argyria, the nail is permanently pigmented a slate-blue color and is most evident in the lunula. Minocycline and Zidovudine can also turn the nail plate blue-gray.[4]

See also

References

  1. ↑ Cao, Lei; Shi, Ren-lin; Tan, Cheng; Bi, Xin Ling; Zang, Ru-Zhi; Chen, Liu-Qing; Yuan, Shan; Rigopoulos, Dimitris; Ma, Dong-Lai; Zhu, Wen-Yuan; Li, Heng-Jin; Yin, Zhi-Quiang (2018). "20. Disorders of skin appendages". In Zhu, Wen-Yuan; Tan, Cheng; Zhang, Ru-zhi (eds.). Atlas of Skin Disorders: Challenging Presentations of Common to Rare Conditions. Singapore: Springer. pp. 303–305. ISBN 978-981-10-8036-4. Archived from the original on 2023-06-30. Retrieved 2023-06-02.
  2. 1 2 3 4 5 6 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. 790. ISBN 978-0-323-54753-6. Archived from the original on 2023-06-30. Retrieved 2023-05-31.
  3. ↑ Johnstone, Ronald B. (2017). "2. Diagnostic clues and "need-to-know" items". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 33. ISBN 978-0-7020-6830-0. Archived from the original on 2023-06-30. Retrieved 2023-05-31.
  4. ↑ Tosti A, Iorizzo M, Piraccini BM, Starace M (July 2006). "The nail in systemic diseases". Dermatol Clin. 24 (3): 341–7. doi:10.1016/j.det.2006.03.005. PMID 16798431. Archived from the original on 2019-12-10. Retrieved 2018-07-15.
Classification
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