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Dermatoloji Kliniğine Başvuran Hastalarda Tırnak Bulguları ile Kardiyak Morbidite Arasındaki İlişki: Prospektif Bir Çalışma

Year 2025, Volume: 42 Issue: 3, 253 - 256, 30.09.2025

Abstract

Giriş: Son çalışmalar, tırnak bulgularının altta yatan kardiyovasküler hastalıkların erken göstergeleri olabileceğini göstermektedir. Bu çalışma, belirli tırnak anomalileri ile diyabet mellitus, hipertansiyon, hiperlipidemi, koroner arter hastalığı, kalp yetmezliği ve kapak hastalıkları arasındaki ilişkileri incelemeyi amaçlamıştır.

Yöntemler: Altı aylık bir dönemde dermatoloji kliniğine tırnak bozuklukları nedeniyle başvuran 103 hasta prospektif olarak değerlendirildi. Hastaların demografik ve klinik verileri, ayrıntılı fizik muayene bulguları ve tıbbi kayıtların titiz bir şekilde incelenmesiyle toplandı. Kardiyovasküler patolojilerin bağımsız belirleyicilerini saptamak amacıyla lojistik regresyon analizi kullanıldı.

Bulgular: Çalışma popülasyonu ortalama 47 ± 7,2 yaşında olup %59 kadın ve %41 erkekten oluşmaktaydı. Terry tırnakları, diyabet mellitus (OR = 5,23; %95 CI: 1,037–26,365, p = 0,045) ve koroner arter hastalığı (OR = 6,25; %95 CI: 1,685–23,168, p = 0,006) ile anlamlı ilişki gösterdi. Muehrcke çizgileri kalp yetmezliği ile (OR = 5,89; %95 CI: 1,663–20,831, p = 0,006) ve kırmızı lunula kapak hastalıkları ile (OR = 4,76; %95 CI: 1,387–16,302; p = 0,013) anlamlı olarak korelasyon gösterdi.

Sonuç: Belirli tırnak bozuklukları, altta yatan kardiyovasküler hastalıkların klinik belirteçleri olarak değerlendirilebilir. Dermatolojik değerlendirme, kardiyovasküler morbiditenin erken tespiti ve yönetimine katkıda bulunabilir.

Ethical Statement

Etik Kurul Onayı: Bu çalışma, Karamanoğlu Mehmet Bey Üniversitesi Tıp Fakültesi Araştırma Etik Kurulu tarafından (onay no. 05-2022/07) 05, 24,2022 tarihinde onaylanmıştır.

References

  • Singh G. Nails in systemic disease. Indian J Dermatol Venereol Leprol. 2011;77(6):646–651. Haber R, Khoury R, Kechichian E, et al. Splinter hemorrhages of the nails: a systematic review of clinical features and associated conditions. Int J Dermatol. 2016;55:1304–10.
  • Meyerson MS, Scher RK. Nail signs of systemic disease. In: Callen JP, Jorizzo JL, Greer, editors. Dermatology. 3rd ed. Philadelphia: Elsevier; 2007.p. 236–245.
  • Yamaguchi T, Shimizu K. Koilonychia in a patient with Heart Failure and Iron Deficiency Anemia. Am J Med. 2022;135(10):e393–e394.
  • Alam M, Scher RK, Bickers DR. Muehrcke's lines in a heart transplant recipient. J Am Acad Dermatol. 2001 Feb;44(2):316–317.
  • American Diabetes Association. Standards of Medical Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S1– S194
  • McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912–4018.
  • Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidemias: Lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019;290:140–205.
  • Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2022;43:561–632
  • McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–3726
  • Fawcett RS, Linford S, Stulberg D. Nail abnormalities: Clues to systemic disease. Am Fam Physician. 2004;69:1417– 1424.
  • Diseases of hair and nails. In: Cecil RL, Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, Pa.: Elsevier/Saunders; 2012.
  • Terry R. White nails in hepatic cirrhosis. Lancet 1954:757–759.
  • Nia AM, Ederer S, Dahlem KM, et al. Terry’s nails: a window to systemic diseases. Am J Med. 2011;124:602–4.
  • Muehrcke RC. The finger-nails in chronic hypoalbuminemia; a new physical sign. Br Med J 1956;1:1327–1328.
  • Short N, Shah C. Muehrcke's lines. Am J Med. 2010;123:991–992.
  • Wolff K, Johnson RA. Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology. 6th ed. New York: McGraw-Hill Professional; 2009
  • Motswaledi MH, Mayayise MC. Nail changes in systemic diseases. SA Fam Pract. 2010;52:409–13
  • Nabai H. Nail changes before and after heart transplantation: personal observation by a physician. Cutis. 1998 Jan;61(1):31-2.
  • Cohen PR. Red lunulae: Case report and literature review. J Am Acad Dermatol. 1992;26:292–4.

The relationship between nail findings and cardiac morbidity in patients visiting a dermatology clinic: A prospective study

Year 2025, Volume: 42 Issue: 3, 253 - 256, 30.09.2025

Abstract

Recent research highlights that dermatological manifestations, particularly nail disorders, can serve as clinical indicators of underlying cardiovascular pathologie. This study aimed to elucidate the association between specific nail findings and cardiovascular morbidities, including diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease, heart failure, and valvular heart disease. A prospective observational study was conducted involving 103 patients who presented with nail disorders at dermatology clinics within a six-month interval. Data were systematically collected through comprehensive clinical examinations and review of medical records, encompassing demographic and clinical parameters. Logistic regression analysis was utilized to identify independent predictors of cardiovascular outcomes. The study cohort had a mean age of 47 ± 7.2 years, comprising 59% female and 41% male participants. Several nail disorders were identified as significant predictors of cardiovascular pathology. Specifically, the presence of Terry's nails was significantly associated with diabetes mellitus (OR = 5.23; 95% CI: 1.037–26.365, p = 0.045) and coronary artery disease (OR = 6.25; 95% CI: 1.685–23.168, p = 0.006). Muehrcke's lines emerged as significant predictors of heart failure (OR = 5.89; 95% CI: 1.663–20.831, p = 0.006), whereas the identification of red lunula was significantly correlated with valvular heart disease (OR = 4.76; 95% CI: 1.387–16.302, p = 0.013). Distinct nail disorders may serve as valuable clinical markers of underlying cardiovascular diseases. Dermatological assessments could, therefore, contribute to early detection and management of cardiovascular morbidity.

Ethical Statement

Ethics Committee Approval: This study was approved by the Research Ethics Committee of Karamanoğlu Mehmet Bey University, Faculty of Medicine (approval no. 05-2022/07.) on 05, 24,2022.

References

  • Singh G. Nails in systemic disease. Indian J Dermatol Venereol Leprol. 2011;77(6):646–651. Haber R, Khoury R, Kechichian E, et al. Splinter hemorrhages of the nails: a systematic review of clinical features and associated conditions. Int J Dermatol. 2016;55:1304–10.
  • Meyerson MS, Scher RK. Nail signs of systemic disease. In: Callen JP, Jorizzo JL, Greer, editors. Dermatology. 3rd ed. Philadelphia: Elsevier; 2007.p. 236–245.
  • Yamaguchi T, Shimizu K. Koilonychia in a patient with Heart Failure and Iron Deficiency Anemia. Am J Med. 2022;135(10):e393–e394.
  • Alam M, Scher RK, Bickers DR. Muehrcke's lines in a heart transplant recipient. J Am Acad Dermatol. 2001 Feb;44(2):316–317.
  • American Diabetes Association. Standards of Medical Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S1– S194
  • McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912–4018.
  • Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidemias: Lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019;290:140–205.
  • Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2022;43:561–632
  • McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–3726
  • Fawcett RS, Linford S, Stulberg D. Nail abnormalities: Clues to systemic disease. Am Fam Physician. 2004;69:1417– 1424.
  • Diseases of hair and nails. In: Cecil RL, Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, Pa.: Elsevier/Saunders; 2012.
  • Terry R. White nails in hepatic cirrhosis. Lancet 1954:757–759.
  • Nia AM, Ederer S, Dahlem KM, et al. Terry’s nails: a window to systemic diseases. Am J Med. 2011;124:602–4.
  • Muehrcke RC. The finger-nails in chronic hypoalbuminemia; a new physical sign. Br Med J 1956;1:1327–1328.
  • Short N, Shah C. Muehrcke's lines. Am J Med. 2010;123:991–992.
  • Wolff K, Johnson RA. Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology. 6th ed. New York: McGraw-Hill Professional; 2009
  • Motswaledi MH, Mayayise MC. Nail changes in systemic diseases. SA Fam Pract. 2010;52:409–13
  • Nabai H. Nail changes before and after heart transplantation: personal observation by a physician. Cutis. 1998 Jan;61(1):31-2.
  • Cohen PR. Red lunulae: Case report and literature review. J Am Acad Dermatol. 1992;26:292–4.
There are 19 citations in total.

Details

Primary Language English
Subjects Cardiology, Dermatology
Journal Section Research Article
Authors

Fadime Bozduman Habip 0000-0002-9895-1132

Hanife Merve Akça 0000-0001-8280-7470

Zuhal Metin 0000-0001-9392-0620

Nazime Bensu Önentaşçı Demir 0000-0002-0354-0868

Publication Date September 30, 2025
Submission Date October 28, 2024
Acceptance Date September 8, 2025
Published in Issue Year 2025 Volume: 42 Issue: 3

Cite

APA Bozduman Habip, F., Akça, H. M., Metin, Z., Önentaşçı Demir, N. B. (2025). The relationship between nail findings and cardiac morbidity in patients visiting a dermatology clinic: A prospective study. Deneysel Ve Klinik Tıp Dergisi, 42(3), 253-256.
AMA Bozduman Habip F, Akça HM, Metin Z, Önentaşçı Demir NB. The relationship between nail findings and cardiac morbidity in patients visiting a dermatology clinic: A prospective study. J. Exp. Clin. Med. September 2025;42(3):253-256.
Chicago Bozduman Habip, Fadime, Hanife Merve Akça, Zuhal Metin, and Nazime Bensu Önentaşçı Demir. “The Relationship Between Nail Findings and Cardiac Morbidity in Patients Visiting a Dermatology Clinic: A Prospective Study”. Deneysel Ve Klinik Tıp Dergisi 42, no. 3 (September 2025): 253-56.
EndNote Bozduman Habip F, Akça HM, Metin Z, Önentaşçı Demir NB (September 1, 2025) The relationship between nail findings and cardiac morbidity in patients visiting a dermatology clinic: A prospective study. Deneysel ve Klinik Tıp Dergisi 42 3 253–256.
IEEE F. Bozduman Habip, H. M. Akça, Z. Metin, and N. B. Önentaşçı Demir, “The relationship between nail findings and cardiac morbidity in patients visiting a dermatology clinic: A prospective study”, J. Exp. Clin. Med., vol. 42, no. 3, pp. 253–256, 2025.
ISNAD Bozduman Habip, Fadime et al. “The Relationship Between Nail Findings and Cardiac Morbidity in Patients Visiting a Dermatology Clinic: A Prospective Study”. Deneysel ve Klinik Tıp Dergisi 42/3 (September2025), 253-256.
JAMA Bozduman Habip F, Akça HM, Metin Z, Önentaşçı Demir NB. The relationship between nail findings and cardiac morbidity in patients visiting a dermatology clinic: A prospective study. J. Exp. Clin. Med. 2025;42:253–256.
MLA Bozduman Habip, Fadime et al. “The Relationship Between Nail Findings and Cardiac Morbidity in Patients Visiting a Dermatology Clinic: A Prospective Study”. Deneysel Ve Klinik Tıp Dergisi, vol. 42, no. 3, 2025, pp. 253-6.
Vancouver Bozduman Habip F, Akça HM, Metin Z, Önentaşçı Demir NB. The relationship between nail findings and cardiac morbidity in patients visiting a dermatology clinic: A prospective study. J. Exp. Clin. Med. 2025;42(3):253-6.