is this terry nail?

[me_just34]

It is 1.5 year that i have fatty liver (nonalcoholic). In last two tests, my liver enzymes and protein level were normal.
Recently, I have  color changing hands  in cold or when I am stressed.
In addition, I started to be suspicious about my nails and wonder if I have terry nails.
The picture of my nails are  at:

http://postimg.org/image/z3a3is4dr/a9924038/

are these terry nails?
I noticed that the color of my nails are changing depending on temperature. For example, under sun I do not have red tips.  Is the color pattern in terry nails fixed? I.e., does it change according to temperature?
I will be happy if you answer my questions.

[me_just34]

Dear Dr., I will be happy if it is possible to comment my new  related problem at:

http://www.medhelp.org/posts/Dermatology/what-is-this-in-the-tip-of--fingernail/show/2234011#post_10720537

Thank you very much in advance.

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.

I can understand your concern for the nail changes given your history of fatty liver.

I have checked the photograph and from the symptoms and photograph, the possibility of terry nail is less likely because the lanula of the nails is visible. In terry nails, the fingernails appear white with a characteristic "ground glass" appearance, with no lunula (the crescent-shaped whitish area of the bed of a fingernail). It is thought to be due to a decrease in vascularity. Hence there appears a red or brown distal transverse band on the tip of fingernail. It is found in severe liver disease like cirrhosis, diabetes mellitus, congestive heart failure, hyperthyroidism, and/or malnutrition. Since your liver enzymes are normal, chances are less likely that you have terry nails. Color pattern in terry nails is fixed and it does not change with temperature.

This can be confirmed by an examination from a dermatologist. When the proximal pallorous nail bed is congested with blood by manually occluding venous outflow, this band must still be easily distinguishable.

For your condition, one important possibility which needs to be ruled out is of Raynaud’s phenomenon. It is an episodic reduction in the blood supply to the fingers and/or toes occurring mainly in response to cold which causes white tips of extremities. This is then sometimes followed by a bright red colour due to a compensatory increased blood flow before the normal skin colour and sensation are restored. If you are having these symptoms then this possibility should be evaluated by a dermatologist. If it is suspected then he may do a nail fold capillary microscopy.

Hope that this information helps and hope that you get better soon.

Wishing you good health.