within the larger capillaries.10 Clubbing can be a sign of numerous underlying diseases, such as cirrhosis, chronic obstructive pulmonary disease, or celiac sprue.KOILONYCHIAKoilonychia (Figure 11) is a condition in which the nail becomes increasingly concave and therefore is often called spoon nail.1 It commonly occurs in association with iron deficiency anemia.10 Koilonychia can be a normal fin