Diseases of the Nails #4
Clubbing is a clinical finding characterized by bulbous fusiform enlargement of the distal portion of a digit in which the angle between the proximal nail fold and the nail plate decreases to less than 160°. The exact pathophysiologic mechanism is unknown. Primary clubbing is caused by pachydermoperiostosis, familial clubbing, and hypertrophic osteoarthropathy. Causes of secondary clubbing include disorders of the lungs (such as lung cancer, interstitial lung disease, cystic fibrosis), heart (including cyanotic congenital heart disease), gastrointestinal tract (such as inflammatory bowel disease, liver cirrhosis, achalasia), and skin (as exemplified by palmoplantar keratoderma), as well as many malignancies, such as thyroid cancer, chronic myeloid leukemia, and other miscellaneous conditions, including acromegaly and pregnancy. There is no specific treatment for clubbing. If the underlying disease process or condition is treated, then the clubbing may improve or resolve.
http://www.medscape.com/features/slideshow/nail-diseases?src=nl_slide
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