Digital clubbing is characterized by an increase in the volume of the soft tissue in the nail beds, with obliteration of the angle formed between the proximal nail fold and nail bed [1]. Digital clubbing can manifest independently, as part of a secondary disease process, or as a component of hypertrophic osteoarthropathy (HOA). HOA is characterized by periostosis in long bones, joint pain, and clubbing. It may also coexist with pachydermoperiostosis, which is characterized by HOA and acromegaly [2, 3]. While the exact mechanism is not fully understood, it is thought that cytokines associated with megakaryocytes play a role in the development of clubbing. Additionally, prostaglandins, ferritin, and growth factors like vascular endothelial growth factor (VEGF), either overproduced or poorly eliminated from affected organs, may be involved in the underlying processes leading to clubbing [4]. Digital clubbing may indicate an underlying medical condition and can offer diagnostic insights during medical assessment. For example, clubbing may regress in cystic fibrosis patients who have undergone lung transplant [4].

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Digital Clubbing

  • Eden Axler,
  • Shari R. Lipner

摘要

Digital clubbing is characterized by an increase in the volume of the soft tissue in the nail beds, with obliteration of the angle formed between the proximal nail fold and nail bed [1]. Digital clubbing can manifest independently, as part of a secondary disease process, or as a component of hypertrophic osteoarthropathy (HOA). HOA is characterized by periostosis in long bones, joint pain, and clubbing. It may also coexist with pachydermoperiostosis, which is characterized by HOA and acromegaly [2, 3]. While the exact mechanism is not fully understood, it is thought that cytokines associated with megakaryocytes play a role in the development of clubbing. Additionally, prostaglandins, ferritin, and growth factors like vascular endothelial growth factor (VEGF), either overproduced or poorly eliminated from affected organs, may be involved in the underlying processes leading to clubbing [4]. Digital clubbing may indicate an underlying medical condition and can offer diagnostic insights during medical assessment. For example, clubbing may regress in cystic fibrosis patients who have undergone lung transplant [4].