Koilonychia

Dear students, welcome back. 

This image shows koilonychia i.e. spoon shaped nail deformities. The typical description is that such nail changes will be able to hold a drop of water. Such abnormal nail changes are usually seen in chronic iron deficiency anemia.

This photo was taken from the hand of a patient diagnosed with Hereditary Hemorrhagic Telangiectasis. As a result of chronic occult bleeding, he was admitted for symptomatic anemia and required blood transfusions. 

It is important to look out for koilonychia when encountering a patient with chronic anemia. Remember to get a complete history regarding chronic blood loss e.g. menorrhagia or bleeding per rectum etc. A complete dietary history confirming reduced iron intake is also important.

CCE.