Unusual Colors Of Fingernails

What Causes Green, Blue, Black, Yellow Fingernails?

Green, blue, black, yellow fingernails can have various causes, ranging in severity from 'minor' to 'generally fatal'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose green, blue, black, yellow fingernails, we could:
  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "green, blue, black, yellow fingernails" as a symptom.  Here are eight of many possibilities (more below):
  • Pulmonary Embolism
  • Pneumonia
  • Wilson's Disease
  • Chemotherapy Side-Effects
  • Emphysema
  • Ochronosis / Alkaptonuria
  • Raynaud's Phenomenon
  • Fungal Infection

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
brittle fingernails
having a high fever
pneumonia
dark urine color
chest pain when breathing
inflamed cuticles
deformed toenails
recent dry cough
recent productive cough
Raynaud's phenomenon
mouth sores
recent chemotherapy use
... and so on

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of green, blue, black, yellow fingernails:
Cause Probability Status
Pulmonary Embolism 94% Confirm
Wilson's Disease 16% Unlikely
Fungal Infection 26% Unlikely
Chemotherapy Side-Effects 5% Ruled out
Pneumonia 2% Ruled out
Raynaud's Phenomenon 0% Ruled out
Emphysema 0% Ruled out
Ochronosis / Alkaptonuria 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate abnormal fingernails and toenails, The Analyst™ will ask further questions including this one:
Are (parts of) your fingernails any unusual color other than white?
Possible responses:
→ No / another color (add a note) / don't know
→ Green / greenish
→ Blue / bluish
→ Black / somewhat brown
→ Yellow / yellowish
Based on your response to this question, which may indicate green/greenish fingernails, blue/bluish fingernails, black/brown fingernails or yellow/yellowish fingernails, The Analyst™ will consider possibilities such as:
(Prescription) Drug Side-Effects
Black nails (melanonychia) can be a medication side-effect, particularly of cyclophosphamide (Cytoxan).
Chemotherapy Side-Effects
Black line(s) across the nails are common in dark-skinned persons but may also be the result of injury or chemotherapy.
Fungal Skin / Nail Infection
Green nails are generally due to a Pseudomonas pyocyanea infection.  One of the most common causes of yellow nails is a fungal infection.  Black nails are a possible indication of bacterial or fungal infection.
HIV/AIDS
Black nails are sometimes seen in people infected with AIDS.
Melanoma
A longitudinal brown-black streak (which may take up the whole nail and may "spill over" into the proximal nail fold) is a sign of melanoma, and possibly Hutchinson's.
Pneumonia
Nails with a bluish tint can mean the body isn't getting enough oxygen.  This could indicate an infection in the lungs, such as pneumonia.

Related Questions

Fingernail/Toenail Symptoms