Idiopathic digital clubbing

A 20-year-old man presented to our outpatient department with complaints of swelling of the distal portions of the fingers and toes, accompanied by abnormal nail curvature.It had gradually evolved over time and had not existed since birth.The patient was otherwise asymptomatic and denied any respiratory, cardiovascular, gastrointestinal or other systemic symptoms.A thorough family history revealed no 1 st -or 2 nd -degree relatives with pachydermoperiostosis, hypertrophic osteoarthropathy or digital clubbing.Cutaneous and nail examination revealed clubbing involving all fingers and toes [Figure 1].Schamroth's sign was positive.Systemic examination was unremarkable.Chest radiography, electrocardiography, echocardiography, inflammatory markers, routine laboratory tests and other pertinent tests were all within normal ranges.No periosteal new bone growth was visible on radiographs of the hands and long bones.A diagnosis of idiopathic digital clubbing was made after primary, secondary and inherited causes were ruled out.