Koilonychia is most commonly associated with which condition?

• A. Iron-deficient anemia
• B. Hyperlipidemia
• C. Diabetes mellitus
• D. Vitamin C deficiency

Answer: (A)

Koilonychia, or spoon-shaped nails, is most commonly a sign of iron-deficiency anemia. When iron stores are low, nail growth slows and the nail plate becomes thinner and curves upward, producing the characteristic concave, spoon-like appearance. This change reflects impaired nail bed health from insufficient iron, and it often accompanies other iron-deficiency signs such as fatigue, pallor, and glossitis. While nails can be affected by various conditions, the spoon-shaped nails are classically linked to iron deficiency rather than to vitamin C deficiency, diabetes mellitus, or hyperlipidemia. If koilonychia is seen, it’s helpful to assess iron status with tests like ferritin and a complete blood count, and to address any underlying causes of iron loss or inadequate intake.