Doctors diagnosing liver disease often see the same sign on the “fingers” of patients with cirrhosis

Many people have early stages of liver disease, and only a small proportion develop serious complications. Unfortunately, diagnosing the disease is not easy, as symptoms rarely appear until the final stages. At this stage of the disease, doctors often encounter nail abnormalities.

In fact, dermatological manifestations are often among the first signs of underlying liver disease.

However, the causes of nail changes associated with liver cirrhosis remain unknown.

Research from the Department of Dermatology at Sohag University suggests that the changes may be due to decreased immunity, iron deficiency, anemia, or old age.

The health authority states: “It is important for clinicians to understand and carefully examine nails for color, texture, thickness and curvature in order to quickly and early diagnose patients with liver disease.”

READ MORE: Three Signs of Stage 4 Liver Disease That Appear on the Skin

In order to understand the prevalence of nail changes, the health authority started a study to study various skin manifestations associated with liver disease.

The medical department noted: “Knocking the fingers is a well-recognized sign of chronic liver disease, especially primary biliary cirrhosis and chronic active hepatitis.

“Terry’s nails, in which the proximal two-thirds of the nail plate becomes powdery white with ground glass opacity, may develop in patients with advanced liver cirrhosis.”

According to the Mount Sinai report, crooked fingers are a symptom of a medical condition, often a heart or lung condition, that causes chronically low oxygen levels in the blood.


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Early studies suggested that the “drumsticks” in cirrhosis of the liver are not the result of bone disease, but rather are caused by increased peripheral blood flow with dilated veins in the finger.

Initially, the nail stick occurs due to softening of the nail bed, followed by an increase in the normal 160-degree angle between the nail bed and the proximal nail fold.

“Eventually, the nail and periungual skin become shiny, and longitudinal grooves appear on the nail,” explains the Saudi Medical Journal.

READ ALSO: Stool color may signal end-stage liver disease

In the study, a total of 80.5% of patients with liver disease were found to have nail changes, indicating a higher prevalence than in earlier studies.

For example, in a 2010 Egyptian study, researchers documented nail changes in 68 percent of patients with liver disease.

In 2013, a study published in the Journal of the Evolution of Medical and Dental Sciences reported nail changes in 72 percent of the specimens examined.

What’s more, a 2018 study published in the International Journal of Research in Dermatology found nail changes in 60 percent of patients with chronic liver disease.

How long does it take for cirrhosis symptoms to appear?

It is generally accepted that the progression of non-alcoholic fatty liver disease at an early stage takes decades.

Recent studies, however, have shown that some cases progress rapidly, within a short time span of two years.

In no particular order, symptoms of cirrhosis typically include:

  • Fatigue
  • Weakness
  • Weight loss
  • Nausea
  • bruises
  • Redness on the palms
  • Spider-like blood vessels on the skin.

Some people are more susceptible to liver cell damage than others, so the symptoms of cirrhosis can develop at different rates in different people.

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