Terry’s Lines

CLINICAL DIAGNOSTIC MANUAL

Terry’s lines are whitish horizontal bands that traverse the nail, typically affecting all nails except the thumbs. These lines may indicate systemic changes and are associated with various medical conditions. Below is a brief description of this clinical sign, suggested complementary tests, and a table listing the pathologies that can produce this alteration.

Pathology	Suspected Diagnosis	Confirmatory Diagnosis
Liver cirrhosis	Fatigue, jaundice, ascites, bleeding, nail changes	Liver ultrasound, liver biopsy, liver function tests
Congestive heart failure	Shortness of breath, peripheral oedema, fatigue, nail changes	Echocardiogram, BNP test (B-type natriuretic peptide)
Diabetes mellitus	Excessive thirst, hunger, frequent urination, blurred vision, nail changes	Fasting glucose test, HbA1c
Cancer	Unexplained weight loss, fatigue, persistent pain, nail changes	Biopsy of affected tissue, imaging studies (e.g., CT or MRI)
Advanced age	Changes in nail quality such as brittleness or colour changes	Clinical diagnosis based on age and physical examination