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General Practice 2023

Digital clubbing: what é, symptoms, causes and treatment

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Digital clubbing: what é, symptoms, causes and treatment
Digital clubbing: what é, symptoms, causes and treatment

Digital clubbing, also known as clubbing, is a swelling of the fingertip and changes in the nail, causing rounding of the fingertip and widening of the nail, which may also be curved downwards and softened, and, may affect fingers or toes.

Generally, clubbing is associated with lung or heart diseases, such as lung cancer, tuberculosis or bacterial endocarditis, for example, and is therefore an important sign of serious illness. In addition, digital clubbing can occur due to genetic alterations, and it is common to appear during childhood or adolescence in families with a history of this condition.

Digital clubbing should always be evaluated by the general practitioner, who can indicate the most appropriate treatment according to its cause, such as lifestyle changes, or use of medication to treat lung or heart disease, and reduce the swelling in the finger.

Main symptoms

Digital clubbing can affect the fingers and/or toes, and the main symptoms include:

  • Fingertip rounding;
  • Enlargement of the nail, which can also be curved downwards;
  • Softening of the nail, which may have a spongy appearance;
  • Redness at the base of the nail.

In addition, the nail and the skin around the nail may appear shiny due to swelling in the finger.

It is important to consult the general practitioner whenever symptoms of digital clubbing appear so that the diagnosis can be made and the most appropriate treatment started according to its cause.

Confirm the diagnosis

Diagnosis of digital clubbing is made by the general practitioner, through the evaluation of symptoms, physical examination and laboratory tests such as complete blood count, liver function tests, blood electrolyte levels, and thyroid tests.See the main tests that evaluate the thyroid.

In addition, the doctor may order tests to evaluate the lungs and heart, such as blood gas analysis, chest X-ray, ultrasound, CT scan, electrocardiogram or echocardiogram, for example.

Possible causes

The causes of digital clubbing are not fully known, however, it seems to be related to changes in blood circulation, causing a dilation of blood vessels in the fingers, usually associated with hereditary factors or due to other diseases, such as:

  • Congenital heart disease;
  • Pulmonary artery malformations;
  • Lung lymphoma;
  • Lung cancer;
  • Tuberculosis;
  • Fibrosis or lung abscess;
  • Bacterial endocarditis;
  • Bronchiectasis;
  • Asbestosis;
  • Chronic inflammation of the digestive system, such as Crohn's disease or ulcerative colitis;
  • Cirrhosis;
  • Cystic Fibrosis;
  • Celiac disease;
  • Hyperthyroidism or Graves' disease;
  • Thalassaemia;
  • Raynaud's Syndrome.

Furthermore, clubbing can occur due to other types of cancer such as liver cancer, bowel cancer or Hodgkin's lymphoma, for example.

How the treatment is done

The treatment of digital clubbing must be guided by the general practitioner and varies according to its cause, and the use of medication or surgery, for example, may be recommended.

In case the digital clubbing was caused by cancer, the doctor may recommend chemotherapy or radiotherapy, and in the case of lung cancer or other serious lung diseases, a lung transplant may be recommended, however this recommendation is infrequent.Learn how lung transplantation is performed.

In cases where clubbing is not related to respiratory diseases, the doctor may recommend the use of specific medications for the cause, in addition to a change in lifestyle.

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