Which statement is true regarding cyanosis in COPD?

• A. Chronic bronchitis cyanosis is more widespread
• B. Emphysema commonly has cyanosis in nail beds
• C. Cyanosis is never seen in COPD
• D. Both diseases show identical cyanosis patterns

Answer: (B)

Cyanosis arises when there is enough deoxygenated hemoglobin in the circulating blood to produce a blue tint, signaling significant hypoxemia. In COPD, emphysema can start as a “pink” process, but as the disease advances and ventilation–perfusion mismatch worsens, oxygen levels fall and deoxygenated blood increases. The nail beds are a sensitive place to notice this change, so cyanosis in the nails can appear in advanced emphysema. This peripheral cyanosis reflects substantial desaturation and is a late sign, which is why the statement about cyanosis in nail beds being seen with emphysema is true.