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Written by:
Elmuhtady Said,
Gastroenterology Registrar, Barnsley District General Hospital, Barnsley, UK
Reviewed by:
Ihab Babiker AbdalRahman, MD
 Assistant Professor of Medicine, University of Khartoum, Sudan
Faroug Yassin, MD
Attending in Internal Medicine, University of Iowa, Iowa City, IA, USA
 

Case Description

A 34-year-old patient presented with alcohol-induced hepatitis. He was a life-long non-smoker and his fingernails are shown in Figures 1 & 2. His hand radiograph was normal and he had no audible heart murmurs. He reported that other members of the family had similar finger appearances.

figure1

figure2

  1. What is the most likely cause of these nail changes? (Select one)
 

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