Systemic Diseases

Arthritic Swelling

Arthritic swelling of the middle joint of a finger is called a Bouchard's node. Swellings at the small finger joints are called Heberden's nodes.

Buerger's Disease

Buerger's disease is one type of occlusive vascular disease that may affect the fingers. It is due to an inflammatory disease called vasculitis and is typically associated with smoking.

This disease affects medium and small arteries, so it often affects the fingers and toes. It may present as a painful, poorly healing wound or ulcer/gangrene at the fingertip. Involvement of multiple fingers is common.

The primary treatment is to avoid smoking. Amputation is sometimes necessary.

Dactylitis

This example of dactylitis was associated with psoriatic arthritis. The swelling extends from the palm to include the ring finger out to the small joint.

Stiffness is common, and there may also be pain. This swelling may improve with medicines for the problem causing it.

Mucous Cyst

A mucous cyst may cause the skin to become thin. If the cyst breaks, it may drain a clear sticky fluid.

The resulting break in the skin may allow bacteria to reach the nearby joint, causing a joint or bone infection.

Red Dots

Small red dots can appear in the thin part of the skin around the nail. They may also occur in the thicker pink part.

This finding has been seen in dermatomyositis, systemic lupus, and scleroderma.

Leukonychia

Leukonychia can be seen with viral infections, intestinal and kidney diseases, poisoning, and medicines.

The nail may come loose from the nail bed because of fungal infections or other causes.

Red Streaks

Red streaks in the fingernail area can be due to hemorrhage, or bleeding. These are called splinter hemorrhages.

Splinter hemorrhages have been seen in endocarditis, which is a heart infection, and have also been reported in psoriasis and trichinosis.

Psoriasis

Psoriasis commonly affects the nail and nailbed. Pits in the nail, loosening, blood streaks beneath the nail, and other changes may occur.

A psoriasis skin patch is shown in the middle of the image.

Pincer Nail

A pincer nail has an abnormal side-to-side curved shape. It can be present at birth or simply be due to aging.

It can also be caused by changes in the bone beneath the nail because of disease, such as gout in the example shown.

Pyogenic Granuloma

A pyogenic granuloma is a fleshy, moist mass or lump that bleeds easily. It can affect the fingers and has also been reported in many other areas of the body.

In the fingers, it is commonly found after trauma to the skin. If there are multiple or recurring lumps, they may be due to the effects of medications or pregnancy.

The most effective treatment is surgery to remove the lump. If it is due to medication, stopping the medication can help.

Terry's Nails

With Terry's nails, fingernails appear milky white or opaque except for a small band of pink/red at the end of the nailbed.

This appearance was first reported to be associated with liver disease and has also been reported with congestive heart failure, type II diabetes, and aging.