Redness of the lunulae — the pale, crescent-shaped areas at the base of the nails — may be associated with heart failure, liver cirrhosis, rheumatoid arthritis and other diseases. This is the conclusion reached by researchers from Rutgers New Jersey Medical School. Their scientific review was published in the American Journal of the Medical Sciences (AJMS).
The lunula forms at the base of the nail, where new keratin cells are produced. It normally has a whitish appearance, while redness is uncommon. According to the review, changes in the color of several lunulae are more often seen in systemic diseases that affect the body as a whole.
“Red lunulae have most often been associated in the scientific literature with cardiovascular, autoimmune and rheumatologic diseases. This sign has also been described in patients with liver disease, connective tissue disorders, alopecia areata and carbon monoxide poisoning,” the researchers noted.
However, a red lunula does not necessarily mean that a person has a disease. Moreover, the mechanism underlying this association has not yet been established. The researchers suggest that the redness may be linked to dilation of the small blood vessels beneath the nail and increased blood flow caused by systemic conditions.
“The number of affected nails also matters. If redness appears in several lunulae at once, it may be more likely to indicate a systemic problem. Redness affecting only one nail, on the other hand, requires local causes to be ruled out — such as a subungual tumor, hemorrhage or infection of the nail bed,” the researchers added.
The authors believe that an unusual lunula color may be a useful signal prompting further medical evaluation. This sign has been known in medicine since the 1950s, but because it is rare, its diagnostic significance often goes unnoticed.
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