Terry's nails are commonly associated with which of the following conditions?

• A. Iron-deficiency anemia
• B. Hyperlipidemia
• C. COPD
• D. Liver failure, cirrhosis, diabetes, CHF, hyperthyroidism and malnutrition

Answer: (D)

Terry's nails reflect a systemic change in the nail bed from chronic illness, not a local nail problem. The nails look mostly pale or white with a narrow pink distal band because long-standing disease alters the nail bed’s color and vascularity.

This pattern is classically associated with liver disease (including liver failure and cirrhosis) and with conditions that affect overall nutrition and circulation, such as congestive heart failure, diabetes, and malnutrition. The association with these chronic conditions helps explain why Terry’s nails appear as they do, and it can also be seen with aging.

So, the presence of this nail pattern most strongly points to liver-related disease, heart failure, and metabolic/nutritional disorders, which is why that option is the best fit. Other choices describe conditions that don’t typically produce this nail finding.