What abnormally colored nails could mean. The nails can be a window to health. Healthy nails are smooth and devoid of ridges grooves, spots, or discoloration. Discolored nails could be a sign of infection, drug reactions, or disease. Brown nails. Diffuse brown nails are a sign of jaundice and can be caused by hyperbilirubinemia, or high bilirubin levels. Elevated levels of bilirubin in the blood may be secondary to liver, gallbladder, or blood disease. Many things can cause brown or black bands to appear on the nails. Chemotherapy agents can cause transverse bands to appear. Antiretroviral medications can result in brown longitudinal bands. Melanoma can cause longitudinal bands to manifest in one single nail. In African Americans, vertical bands are found in more than 90% of people. Malnutrition can cause diffuse brown or black bands. Green nails. Green streaks and patches on nails can be indicative of infection with Pseudomonas, a type of bacteria that can cause ear infections and skin rashes. People are usually exposed to Pseudomonas in water, such as hot tubs (hot tub rash). Opaque nails. Leukonychia totalis results in “porcelain nails” in which the nail beds that are completely white. This condition is usually inherited as autosomal dominant and caused by mutations in the PLCD1 gene. In some, leukonychia totalis is part of a syndrome and co-occurs with a constellation of other symptoms, including kidney stones, photophobia, and type 2 diabetes. Blue nails. Diffuse blue nails can be a sign of Wilson’s disease, which is caused by excess copper accumulating in the organs. Diffuse blue nails can also be caused by the AIDS drug Zidovudine, antimalarial drugs, and the antibiotic minocycline. Blue-gray nails can result from silver exposure, also called argyria. On a related note, bleeding under the nail can also present as an irregular blue pattern. Yellow nails. Yellow nail syndrome is rare and caused by hindrance of the lymphatic circulation, with nails being malformed. In people with this condition—typically older adults—lymph accumulates under soft tissue and can cause swelling, or lymphedema, in various parts of the body. People with this condition also experience lung abnormalities. Black nails. Fungal infections can cause nails to turn black (or brown). Antimalarial drugs or overexposure to fluoride (ie, fluorosis) can also cause nails to turn black. Please note that this list is merely meant as food for thought. Any diagnosis based on nail findings should be done by a physician. Suffice it to say, discolored nails could possibly be an indication of illness and warrant a visit with a physician.
