Inspect the Hands

Is clubbing of the fingernails present? The technique for evaluating clubbing is described in Chapter 8, The Skin. The earliest finding of clubbing is loss of the angle between the nail and the terminal phalanx. Look at Figure 8-12, in which a normal index fingernail is compared with a severely clubbed index fingernail of a patient with bronchogenic carcinoma.

Clubbing has been associated with a number of clinical disorders, such as the following:

Intrathoracic tumors Mixed venous-to-arterial shunts Chronic pulmonary disease Chronic hepatic fibrosis

The pathogenesis of clubbing is unclear. In many conditions, however, arterial desaturation occurs. This, in some way, may be the underlying problem. In some individuals, clubbing may be inherited without any pathologic process.

Mole Removal

Mole Removal

Moles, warts, and other unsightly irregularities of the skin can be bothersome and even embarrassing. They can be removed naturally... Removing Warts and Moles Naturally! If you have moles, warts, and other skin irregularities that you cannot cover up affecting the way you look, you can have them removed. Doctors can be extremely expensive. Learn the natural ways you can remove these irregularities in the comfort of your own home.

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