Terry's nails: a review of the literature

Abstract

Terry's nails are classified as a type of apparent leukonychia and are usually defined as the proximal, white part of the nail that occupies 80% of the nail, and a brownish to pink distal band that occupies 0.5-3.0 mm of the nail from the side of the free edge of the nail. Lunula may or may not be present. The pathogenesis of Terry's nails has not been fully understood. The dominant hypothesis is that the occurrence of Terry's nails is associated with abnormal nail bed vascularity and the presence of distal teleangiectasias. Differential diagnosis includes half-and-half nails, neapolitan nails, and Muehrcke's nails. Terry's nails are mainly associated with liver cirrhosis, heart failure and adult-onset diabetes mellitus; however, their occurrence may also be associated with advanced age, as well as other systemic diseases.