Watch glass nails

Watch glass nails on fingers or toes are the symptom of hypoxia in the connective tissue of the nail bed. The nail changes are causally related to heart and lung diseases. With the treatment of the primary disease, the symptom of the watch glass nails also improves in this context.

What are watch glass nails?

Hypertrophies correspond to an enlargement of certain tissues or organs with the same number of cells. So-called watch glass nails are found in hypertrophy of connective tissue in the nail bed. It is a form of pathologically altered fingernails. The toenails are less often affected.

In most cases, watch glass nails are associated with drumstick fingers, which drive the nails open into the shape of a piston through a thickening of the finger end links. A watch glass nail is larger, usually rounded and more curved than a normal fingernail. As a rule, the nail anomalies are the symptom of a general disease.

Symptoms of the abnormalities are primarily associated with diseases that are associated with cyanosis, lack of oxygen and thus the bluish discoloration of the skin or mucous membranes. The affected fingernails or toenails are strongly arched in the longitudinal and transverse directions. All fingers and toes or a single finger or toe phalanx can be affected by the pathological changes in the nail bed.

causes

Watch glass nails are to be understood as a symptom of higher-level diseases. The diseases associated with the abnormality usually produce hypoxia in certain tissues. Tissue hypoxia is the breeding ground for watch glass nails. There is an increased formation of growth factors that hypertrophy the connective tissue within the nail bed. Connective tissue lies in the nail bed between the bone and the nail matrix.

The hypoxic formation of new vessels such as capillaries is assumed to be the causative factor for the increased production of growth factors. This new formation of capillaries primarily affects the phalanxes of the fingers. If watch glass nails appear together with drumstick fingers, it is usually due to a heart or lung disease.

These diseases often cause local or systemic tissue hypoxia, which leads to a lack of oxygen. Capillary blood carries oxygen. Since tissue depends on a supply of oxygen to survive, capillaries are formed to compensate for the lack of oxygen.

Watch glass nails are therefore mostly the result of chronic lung or heart diseases such as pulmonary emphysema, pulmonary fibrosis or right-left shunt. If watch glass nails appear individually, the phenomenon is often based on local vascular changes, such as an aneurysm or arteriovenous fistula.

Diseases with this symptom

• hypertrophy
• Pulmonary fibrosis
• COPD

• cyanosis
• Emphysema
• Lung cancer

• Hypoxia
• Lung disease
• Smoker's leg

Diagnosis & course

In patients with watch glass nails, some or all of the fingernails or toenails are abnormally changed.In most cases, the patients also suffer from drumstick fingers in the form of a conspicuously rounded swelling of the distal phalanxes of the fingers, which is associated with soft tissue thickening.

In this case, the patient's watch glass nails are thickened into the shape of a piston through the thickening of the phalanx of the fingers. The shape of the nails is also abnormal. The affected nails appear unusually large, rounded and above all arched outwards. Depending on the primary cause, watch glass nails are associated with other symptoms.

Since the primary cause is usually cardiopulmonary diseases, there are often circulatory disorders that manifest themselves in a bluish discoloration of various tissues. This so-called cyanosis is due to a low level of oxygen saturation in the blood, which is characteristic of many heart-lung diseases. In addition, there are local heart or lung symptoms such as shortness of breath or cardiac arrhythmias.

Watch glass nails are recognized by visual diagnosis. As part of the diagnosis, the symptom is attributed to a primary disease, which requires extensive examinations of the heart and lungs. In most cases the symptom is recognized and the doctor is moved to investigate the cause.

A diagnosis of a cardiopulmonary disease, to which the symptom can be traced back, is less often already before the detection of watch glass nails. For example, acute damage to lung tissue may have been diagnosed, which only gives rise to watch glass nails 14 days later. The prognosis for patients with watch glass nails depends on the cause of the primary hypoxia and its treatability.

Complications

Watch glass nails arise as a result of various lung diseases such as hyperinflation of the lungs (emphysema). The alveoli can burst and the air can escape into the pleural space. This can cause the lungs to collapse (pneumothorax). Coupled with chronic bronchitis, which often results from smoking, there is talk of COPD (chronic obstructive pulmonary disease), which greatly reduces life expectancy.

Overinflation also leads to an increase in blood pressure in the area of ​​the pulmonary arteries. The right heart, which pumps blood into the pulmonary circulation, is overloaded and heart failure (heart failure) can develop. This weak heart can cause irregular heartbeat (arrhythmias). Atrial fibrillation carries the risk of pulmonary embolism or a stroke, while ventricular fibrillation can lead directly to cardiac death.

Asthma can also cause watch glass nails. The dreaded complication of asthma is the status asthmaticus, a condition that cannot be treated with medication but must be monitored by intensive care. This can lead to unconsciousness.

If hepatitis is chronic, it can progress to cirrhosis of the liver, which can eventually also turn into liver cancer (liver carcinoma). Cirrhosis of the liver often leads to edema and accumulation of water in the abdomen (ascites). In addition, the affected person has coagulation disorders. It is not uncommon for the spleen to enlarge and thus additional pain.

When should you go to the doctor?

Watch glass nails often appear in connection with piston-like fingertips, the so-called drumstick fingers. If the piston fingers are congenital and do not show any drastic change, a doctor's visit is not necessary. As soon as a change occurs in the form that the fingernails arch like a watch glass, it is to be understood as a signal.

In most cases, watch glass nails indicate a disease of internal organs. It is therefore advisable to see a doctor as soon as there is difficulty in breathing or coughing or the patient's performance deteriorates. They provide information about functional disorders of the gastrointestinal tract or the liver. Watch glass nails can also be a sign that there is a lack of oxygen due to a lung or heart disease.

Lung cancer is the number one cause of watch glass nails. However, it can also be an indication of pulmonary tuberculosis or another lung disease. Chronic heart failure or cirrhosis of the liver are also possible causes of watch glass nails.

After recording the patient's medical history, the doctor will perform a chest exam. Furthermore, a differential blood count is used to search for evidence of an oxygen deficiency. The ratio of kidney, liver and thyroid values ​​in the blood is also examined. A lung specimen or an ultrasound examination of the heart also help to track down the disease that is the basis of the watch nails.

Doctors & therapists in your area

Treatment & Therapy

Watch glass nails are usually not treated symptomatically. Symptomatic treatment does not make sense because the nail changes do not in themselves pose a health risk. However, the primary cause of the changes can be associated with a more or less serious health risk. Therefore, the causal treatment of watch glass nails is in the foreground.

A causal arteriovenous fistula is removed as far as possible. Causal aneurysms are, if possible, brought to dissolve with medication. These measures restore the permeability of the vessels. The oxygen supply in the tissue normalizes and the watch glass nails recede.

If heart or lung diseases are present, these diseases are improved by means of invasive surgical and medicinal treatments. As soon as the oxygen supply improves, the hypoxia symptom of the watch glass nails also decreases.

Serious lung and heart diseases can only be remedied by a transplant. In these cases, the abnormal nails persist until the patient receives a donor organ. This is especially the case with major tissue damage in the lungs and heart area.

Outlook & forecast

In most cases, watch glass nails indicate a severe chronic disease. Should these occur, a doctor must be consulted. The watch glass nails themselves can cause severe pain for the patient. These can be contained with pain relievers, but pain relievers should not be taken over a long period of time.

The change in the nail itself is not a dangerous condition for the body and is therefore not treated directly. The watch glass nails will recede on their own once the triggering symptom has been treated.

For many people, the watch glass nails are considered unattractive and unaesthetic. As a result, it can lead to decreased self-esteem and psychological problems.

If the watch glass nails occur at the same time as a heart disease or a lung disease, a surgical procedure is usually necessary. The success of this procedure depends heavily on the patient's condition and on the procedure itself.

If the watch glass nails are extremely pronounced, the nail can be completely removed on the finger. This grows back again. However, the underlying symptom for the watch glass nails must be treated in each case. For this reason, no general prediction of the course of this symptom is possible.

prevention

Watch glass nails can only be prevented to the extent that hypoxia of the connective tissue of the nail bed can be prevented. Circulation-promoting measures can largely be understood as preventive measures. Likewise, prophylactic steps to avoid heart and lung diseases in the broadest sense are to be understood as preventive measures, for example exercise, a balanced diet and abstaining from nicotine consumption.

You can do that yourself

If you have watch glass nails, you should always go to your doctor first. Depending on the cause, the medical treatment can be supported by some self-help tips and resources from household and nature.

If the symptoms are due to a heart or lung disease, athletic and dietary measures are recommended. In consultation with the doctor, physiotherapy and yoga can be started. Avoiding harmful food and beverages should first be discussed with your family doctor or a nutrition expert in order to avoid complications. Cosmetic measures such as colorless nail polish can restore the original color of the nails. Home remedies such as olive oil or lemon juice can at least contain the watch glass nails - but not permanently.

The causal treatment of the complaints always has priority and should automatically lead to the regression of the watch glass nails. It is a good idea to maintain a healthy lifestyle even after surgery. This allows the nail health to be preserved permanently. Damaged nails can be repaired by various means such as tea tree oil, molasses or apple cider vinegar. Foods with vitamin E and biotin also contribute to the health of the nails.