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Clubbing of the fingers or toes

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Definition:

Clubbing is a thickening of the flesh under toe and finger nails. The nail curves downward, instead of lying flat.

Alternative Names:

Clubbing

Considerations:

Clubbing is associated with a wide number of diseases. It is most often noted in heart and lung diseases that cause decreased blood oxygen and blue skin ( cyanosis ).

Clubbing may also be due to lung lung cancer, and diseases of the liver and the gastrointestinal tract.

Clubbing may also occur in families. In this case it may not be due to an underlying disease.

Common Causes:

• Congenital heart disease (cyanotic type)
  • Tetralogy of Fallot
  • Tricuspid atresia
  • Transposition of the great vessels
  • Total anomalous venous return
  • Truncus arteriosus
• Cystic fibrosis
• Bronchiectasis
• Lung abscess
• Crohn's disease
• Celiac disease
• Cirrhosis
• Lung cancer
• Pulmonary fibrosis

References:

Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine , 7th ed. St. Louis, Mo; WB Saunders; 2005:78-79.

Murray J, Nadel J. Textbook of Respiratory Medicine . 3rd ed. Philadelphia, Pa: WB Saunders; 2000:506. 

Spicknall KE. Clubbing: an update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance. J Am Acad Dermatol . 2005; 52(6): 1020-8

• Review Date: 2/14/2006
• Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, CriticalCare & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Reviewprovided by VeriMed Healthcare Network.

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