Nail Changes Associated With Thyroid Disease

The document reviews the literature on nail changes in patients with thyroid disease, concluding that certain nail conditions can be indicative of thyroid disorders. Onycholysis (nail separation) and slow-growing, thin nails are associated with hypothyroidism, while onycholysis, koilonychia (spoon-shaped nails), and brittle nails are associated with hyperthyroidism. The study also found that nail clubbing is a manifestation of thyroid acropachy in Graves disease and affects other hyperthyroid patients. The review included eight studies, with a higher representation of females (70%-94%). Other physical findings in thyroid patients included xerosis (dry skin), pruritus (itching), and alopecia (hair loss). Among hypothyroid patients, common nail changes included fragility, slow growth, thinning, onycholysis, and brittleness. Among hyperthyroid patients, the most common nail changes were koilonychia, softening, onycholysis, and brittleness. Additional cutaneous findings of thyroid disorder included xerosis, alopecia, pruritus, and weight change.