Spoon-shaped or spooning fingernails refers to a concavity in the fingernail itself, resulting in a depression in the nail that gives an appearance of a spoon shape to the entire nail. This growth disturbance in the nail is medically known as koilonychia. The spooning is typically such that a water droplet may be placed and held in the depression within the nail. This pattern can sometimes be seen in normal infants, but it disappears as the child ages. Koilonychia is a component of the nail-patella syndrome, a genetic disease characterized by numerous abnormalities including musculoskeletal and kidney abnormalities. Spooning fingernails can also result from trauma, exposure to certain solvents, or it may be associated with chronic medical conditions. In particular, koilonychias is associated with iron deficiency.
Other causes of koilonychia
- Darier's Disease
- LEOPARD Syndrome
- Medications
- Nail-Patella Syndrome
- Normal Infancy
- Plummer-Vinson Syndrome Malnutrition
- Protein Deficiency
- Toxins (Petroleum-Based Solvents)
- Trichothiodystrophy
Fawcett, Robert S., et al. "Nail Abnormalities: Clues to Systemic Disease." Am Family Physician 69.6 Mar. 15, 2004: 1417-1424.
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Causes of Koilonychia
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Celiac Disease
Celiac disease is a condition in which a person has inflammation of the small intestinal mucosa when exposed to gluten in the diet. Symptoms of celiac disease include bloating, nausea, diarrhea, and abdominal discomfort. Treatment is a gluten free diet. Some individuals may have refractory celiac disease in which they do not respond to a gluten free diet.
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Hemochromatosis (Iron Overload)
Hereditary hemochromatosis (iron overload) is an inherited disorder in which there is excessive accumulation of iron in the body. Individuals may have no symptoms or signs, or they can have severe symptoms and signs of iron overload. The most effective treatment for hemochromatosis is therapeutic phlebotomy.
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Iron Deficiency
Iron is a mineral our bodies need. Iron deficiency is a condition resulting from not enough iron in the body. It is the most common nutritional deficiency and the leading cause in the US. Iron deficiency is caused due to increased iron deficiency from diseases, nutritional deficiency, or blood loss and the body's inability to intake or absorb iron. Children, teen girls, pregnant women, and babies are at most risk for developing iron deficiency. Symptoms of iron deficiency include feeling weak and tired, decreased work or school performance, slow social development, difficulty maintaining body temperature, decreased immune function, and an inflamed tongue. Blood tests can confirm an iron deficiency in an individual. Treatment depends on the cause of the deficiency. Proper diet that includes recommended daily allowances of iron may prevent some cases of iron deficiency.
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Lichen Planus
Lichen planus is a common skin disease that features small, itchy pink or purple spots on the arms or legs. the abnormal areas on the skin in lichen planus are typically flat-topped (hence the term planus), itchy, and frequently have a polygonal or angular shape.
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Lupus (Systemic Lupus Erythematosus or SLE)
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE).
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Raynaud's Phenomenon
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
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