The Mnemonic “LEAP ON” will help in physical examination of nails during your clinical rounds as well as during med exams.
Changes in nail are often a harbinger of other systemic diseases. This is why a thorough physical examination is very essential to remove other possible health conditions
Here is a step by step examination sequence of nails in the form of a mnemonic
Step By Step Approach to Examining Nails
- L – Look across the nail bed from the side of each finger.
- E – Estimate the interphalangeal depth at the level of the distal interphalangeal joint and nail bed.
- A – Assess the nail-bed (hyponychial) angle.
- P – Place the nails of corresponding (ring) fingers back to back and look for Schamroth’s window sign.
- O – Observe for fluctuant movement of the nail on the nail bed using thumbs and index fingers.
- N – Note if the interphalangeal depth ratio is >1, the nail fold angle is >190 degrees, and Schamroth’s window sign is absent.
Mnemonic: “LEAP ON“