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Nails can act as a barometer of an individual's health, offer clues to nutritional disturbances and serve as windows through which to view capillary changes associated with constitutional disease. Understanding growth and development of normal nails is essential to the identification and interpretation of nail pathology. Causes of onychopathology include genetic disease, trauma, tumors, dermatologic disease, miscellaneous acquired disorders and generalized systemic disease. Diagnosis is aided by the realization that the nails have a limited number of reaction patterns when disturbed by disease. Any of these reactions may manifest a host of disorders. Clinicians should remember to include the nails in patient assessment. The nails are interesting anatomical and physiological areas that can help make a diagnosis.