Development of Terry's nails after a gastrointestinal bleed

Terry's nails are characterized by white opacification of the nails with effacement of the lunula and distal sparing. Described originally in 1954 by Dr. Richard Terry as a common fingernail abnormality in patients with hepatic cirrhosis, Terry's nails are now a known sequelae of other conditions such as congestive heart failure, chronic kidney disease, diabetes mellitus, and malnutrition. Often all nails of the hands are affected. Treatment of the underlying disease may result in resolution. We present a case of a 77-year-old man who developed Terry's nails following an acute gastrointestinal bleed and subsequent hemorrhagic shock. The development of Terry's nails after a gastrointestinal bleed has not been previously reported.