eMedicine Specialties > Dermatology > Nails

Clubbing of the Nails: Treatment & Medication

Author: Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Coauthor(s): Gregory M Richards, MD, Staff Physician, Department of Human Oncology, University of Wisconsin School of Medicine and Public Health; Instructor of Radiotherapy Technology (RT 412), University of Wisconsin; Supriya Goyal, MD, Consulting Dermatologist
Contributor Information and Disclosures

Updated: Jun 12, 2009

Treatment

Medical Care

No specific treatment for clubbing is available. Treatment of the underlying pathological condition may decrease the clubbing or, potentially, reverse it if performed early enough. Once substantial chronic tissue changes, including increased collagen deposition, have occurred, reversal is unlikely. Treatment for related problems, such as pain, is symptomatic.

Surgical Care

No specific surgical procedures are performed for clubbing. Appropriate surgical treatment of underlying disease, such as tumor removal in patients with lung cancer, may improve or reverse clubbing, provided that permanent morphologic changes have not occurred.

Consultations

Clubbing is a clinical sign of many pathological processes; therefore, consultation with specialists may be necessary to diagnose the underlying disease. Patients with primary hypertrophic osteoarthropathy should be evaluated for associated findings, possibly including myelofibrosis.26,27

Medication

Definitive medical therapy is tailored to the underlying disease process and may include symptomatic treatment of the sequelae of clubbing.

More on Clubbing of the Nails

Overview: Clubbing of the Nails
Differential Diagnoses & Workup: Clubbing of the Nails
Treatment & Medication: Clubbing of the Nails
Follow-up: Clubbing of the Nails
Multimedia: Clubbing of the Nails
References
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References

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  36. Malmquist J, Ericsson B, Hulten-Nosslin MB, Jeppsson JO, Ljungberg O. Finger clubbing and aspartylglucosamine excretion in a laxative-abusing patient. Postgrad Med J. Dec 1980;56(662):862-4. [Medline].

  37. Oikarinen A, Palatsi R, Kylmaniemi M, Keski-Oja J, Risteli J, Kallioinen M. Pachydermoperiostosis: analysis of the connective tissue abnormality in one family. J Am Acad Dermatol. Dec 1994;31(6):947-53. [Medline].

  38. Siragusa M, Schepis C, Cosentino FI, Spada RS, Toscano G, Ferri R. Nail pathology in patients with hemiplegia. Br J Dermatol. Mar 2001;144(3):557-60. [Medline].

  39. Spicknall KE, Zirwas MJ, English JC 3rd. Clubbing: an update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance. J Am Acad Dermatol. Jun 2005;52(6):1020-8. [Medline].

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Further Reading

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Keywords

hippocratic nails, hippocratic fingers, acropachy, dysacromelia, Trommelschlegelfinger, clubbing, digital clubbing, finger clubbing

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Contributor Information and Disclosures

Author

Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Coauthor(s)

Gregory M Richards, MD, Staff Physician, Department of Human Oncology, University of Wisconsin School of Medicine and Public Health; Instructor of Radiotherapy Technology (RT 412), University of Wisconsin
Gregory M Richards, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Radiology, American Medical Association, American Roentgen Ray Society, American Society of Clinical Oncology, American Society of Therapeutic Radiation Oncology, and Radiological Society of North America
Disclosure: Nothing to disclose.

Supriya Goyal, MD, Consulting Dermatologist
Supriya Goyal, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Medical Editor

Richard K Scher, MD, Professor of Dermatology, University of North Carolina
Richard K Scher, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Cryosurgery, American College of Physicians, American Dermatological Association, American Geriatrics Society, American Medical Association, Association of Military Surgeons of the US, International Society for Dermatologic Surgery, New York Academy of Sciences, Noah Worcester Dermatological Society, Rhode Island Medical Society, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Warren R Heymann, MD, Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey
Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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