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To the Editor.—
Nixon and Samols article, "Acral Changes Associated with Thyroid Disease" (212:1175, 1970) neglects to mention an important and common acral sign of thyroid dysfunction ( most commonly seen in hyperthyroidism, but also occasionally seen in hypothyroidism). This is onycholysis, or separation of the distal nail from the nail bed. The figure demonstrates this finding clearly in the fourth and fifth digits of both hands.
Hamburger JI. Onycholysis in Thyroid Disease. JAMA. 1970;213(7):1195. doi:10.1001/jama.1970.03170330075022