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The blood reaching the extremities is not oxygen-rich and when viewed through the skin a combination of factors can lead to the appearance of a blue color. All factors contributing to central cyanosis can also cause peripheral symptoms to appear, but peripheral cyanosis can be observed in the absence of heart or lung failures. [5]
Koilonychia, also known as spoon nails, [1]: 782 is a nail disease that can be a sign of hypochromic anemia, especially iron-deficiency anemia. [ 2 ] : 656 [ 3 ] It refers to abnormally thin nails (usually of the hand) which have lost their convexity, becoming flat or even concave in shape.
Blue nails, or more formally azure lunula, are characterized by a blue discoloration of the lunulae, seen in argyria and cases of hepatolenticular degeneration (Wilson's disease), also having been reported in hemoglobin M disease and hereditary acrolabial telangiectases.
Red blood cells normally survive an average of about 120 days, becoming damaged (their oxygen-carrying capacity becomes compromised) as they age.
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Nail clubbing - nails that curve down around the fingertips with nailbeds that bulge is associated with oxygen deprivation and lung, heart, or liver disease. Koilonychia - spooning, or nails that grow upwards. Associated with iron-deficiency anaemia or vitamin B 12 deficiency. [citation needed] Pitting of the nails is associated with psoriasis.
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Main symptoms that may appear in anemia [20] The hand of a person with severe anemia (on the left, with ring) compared to one without (on the right). A person with anemia may not have any symptoms, depending on the underlying cause, and no symptoms may be noticed, as the anemia is initially mild, and then the symptoms become worse as the anemia worsens.