Alcohol crosses the blood–brain barrier and both directly and indirectly affects a developing fetus. Diagnosis is based on the signs and symptoms in the person.Fetal alcohol spectrum disorders are preventable by the mothers avoiding alcohol during pregnancy. For this reason, medical authorities recommend that women completely avoid drinking alcohol during pregnancy and while trying to conceive. Although the condition is permanent, treatment can improve outcomes. Interventions may include parent–child interaction therapy, efforts to modify child behavior, and drugs.FASD is estimated to affect between 1% and 5% of people in the United States and Western Europe. FAS is believed to occur in between 0.2 and 9 per 1,000 live births in the United States. In South Africa, some populations have rates as high as 9%. The negative effects of alcohol during pregnancy have been described since ancient times. The lifetime cost per child with FAS in the United States was $2 million in 2002; however in 2021, Canada revealed that the annual cost for FASD individuals was $9.7 billion (including the costs of the Criminal Justice System, healthcare, and education among others). The term fetal alcohol syndrome was first used in 1973. Types
FASDs encompass a range of physical and neurodevelopmental problems that can result from prenatal alcohol exposure. The most severe condition is called fetal alcohol syndrome (FAS), which refers to individuals who have a specific set of birth defects and neurodevelopmental disorders characteristic of the diagnosis.Some accept only FAS as a diagnosis, seeing the evidence as inconclusive with respect to other types.
Koilonychia, also known as spoon nails,: 782  is a nail disease that can be a sign of hypochromic anemia, especially  iron-deficiency anemia. : 656  It refers to abnormally thin nails (usually of the hand) which have lost their convexity, becoming flat or even concave in shape. In a sense, koilonychia is the opposite of nail clubbing. In early stages nails may be brittle and chip or break
easily. Koilonychia is associated with Plummer–Vinson syndrome and iron deficiency anemia. It has also been associated with lichen planus, syphilis, and rheumatic fever. The term is from the Greek: κοῖλος, koilos, "hollow", ὄνυξ, onyx, "nail". Even though Koilonychia has been associated with iron deficiency in case reports, it is more likely seen as an occupational change in nails and may be idiopathic; ruling out iron deficiency anemia in these patients is the only work-up necessary in this condition. See also
Kyrle disease
List of cutaneous conditions

References
External links

DermAtlas 1726262099