What is clubbing, and why does it occur?

Question

Hi doctor,

I am a 41-year-old male, and I have noticed that my fingernails are curving downwards over the past three years. I had the habit of smoking for about 20 years and did quit it a few years back. I also have Ulcerative Colitis, and also it seems that I have a Schamroth window. Is it something I should be concerned about? I have also attached the pictures. I am currently taking tablet Mesalamine 400 mg.

Answer 1

Hello,

Welcome to icliniq.com

I can understand your concern. The pictures provided (attachment removed to protect patient's identity), seem to be clubbing due to Ulcerative colitis (chronic inflammatory bowel disease); however, close pictures are needed to confirm the diagnosis.

In clubbing, nail beds become soft and may be loosely attached to the nails. The tips of fingers may get enlarged with the nails curving downwards. In the Schamroth window test, two fingers are held back against each other. Between the nail beds and the nails of the two fingers, a diamond-shaped window usually appears in the usual fingers, whereas in the case of clubbing, the diamond-shaped window or space is missing.

Clubbing is not a disease, and it needs no medical treatment. It is the sign of an underlying illness like inflammatory bowel diseases (IBD) namely, ulcerative colitis.

Controlling the progression of ulcerative colitis is needed.

Take care and let me know if I can assist you further.