Blue nails

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Azure Lunula

Blue nails, or more formally azure lunula, are characterized by a blue discoloration of the lunulae, seen in argyria and cases of hepatolenticular degeneration (Wilson's disease), also having been reported in hemoglobin M disease and hereditary acrolabial telangiectases.[1]

In Wilson's disease the blue color involves the lunula (most intense pigmentation) and fades proximally. In argyria, the nail is permanently pigmented a slate-blue color and is most evident in the lunula. Minocycline and Zidovudine can also turn the nail plate blue-gray.[2] There are also reports of hydroxyurea as a rare cause.


In season 6 of House MD in the episode 12 titled Remorse, House diagnoses his patient with Wilson's Disease in absence of Kayser-Fleischer rings by removing the nail polish to note the blue nails.

See also[edit]


  1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  2. ^ Tosti A, Iorizzo M, Piraccini BM, Starace M (July 2006). "The nail in systemic diseases". Dermatol Clin. 24 (3): 341–7. doi:10.1016/j.det.2006.03.005. PMID 16798431.

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