Medicines for Finger clubbing

What it is

Finger clubbing (also called digital clubbing) is a change in the shape of the ends of the fingers (and sometimes toes) and the nails, which develops gradually over time. The changes include the nail bed becoming softer and the nail curving more, the angle between the nail and the finger being lost, the fingertips becoming broader and rounder ("drumstick" shaped), and sometimes a spongy feeling at the base of the nail. Clubbing itself does not cause symptoms, and is usually noticed as a change in the appearance of the fingers. Its significance is that, while it can occasionally be harmless or run in families (a small number of people have longstanding clubbing with no underlying disease), clubbing is often a sign of an underlying condition — most classically conditions affecting the lungs and heart, but also some conditions of the gut and liver, and, importantly, it can be associated with certain cancers (particularly lung cancer). Because it can be a clue to an underlying condition, new or developing finger clubbing should be assessed to look for a cause, even though it is not itself harmful and does not always indicate serious disease.

How it is treated

When finger clubbing is noticed, the approach is to look for an underlying cause, since clubbing is a sign rather than a disease in itself. A doctor will take a history (including any respiratory, heart, or digestive symptoms, and smoking history), examine the person, and consider whether the clubbing is new or long-standing (long-standing, unchanged clubbing, sometimes present since youth or running in the family, is more likely to be benign). Investigations are guided by the clinical picture and may include a chest X-ray (or other imaging), blood tests, and further tests directed at the likely causes — for example looking at the lungs, heart, or digestive system. Because clubbing can occasionally be associated with lung cancer and other serious conditions, new clubbing, particularly in a smoker or with other symptoms, is taken seriously and investigated. If an underlying condition is found, it is treated on its own merits, and the clubbing may improve if the cause is treatable. Where no underlying cause is found and the clubbing is long-standing or familial, this is reassuring. The reassuring message is that finger clubbing is a useful clue that prompts looking for an underlying condition, and that while it can occasionally be harmless or familial, new clubbing should be assessed so any underlying cause can be found and treated.