Fishy smelling urine is a primary identifying symptom in infant children (Trimethylaminuria literally meaning "trimethylamine in urine"). Trimethylamine is also released in the persons sweat, reproductive fluids, and breath, and can give off a fishy odor when the concentration of trimethylamine is high enough to be detected. The intensity of the smell is directly correlated with the concentration of trimethylamine in the bloodstream. Some people with trimethylaminuria report having a strong odor all the time, but when in a clinical setting most have only moderate to no smell, depending on diet and the severity of their FM03 mutation. In a study by Wise PM, of 115 identified tmau subjects, 0% had a smell detectable at a social distance and only 5% had some minor malodour when sniffing their palms. After a choline challenge load test (intentionally ingesting a TMA precursor) only 10% expressed a smell at a social distance, suggesting that those that produced odour had a more severe form of FMO3 impairment. Smell events are often sporadic and episodic in nature (based on diet over the previous 24 hours), making it often difficult to diagnose by smell alone. Individuals with this condition do not have any physical symptoms, and they typically appear healthy.The condition seems to be more common in women than men, for unknown reasons. Scientists suspect that such female sex hormones as progesterone and estrogen aggravate the condition. According to several reports, the condition worsens around puberty.
Acroosteolysis is resorption of the distal bony phalanges. Acroosteolysis has two patterns of resorption in adults:  diffuse and bandlike. The diffuse pattern of resorption has a widely diverse differential diagnosis which includes:  pyknodysostosis, collagen vascular disease and vasculitis, Raynauds neuropathy, trauma, epidermolysis bullosa, psoriasis, frostbite, sarcoidosis, hypertrophic osteoarthropathy, acromegaly, and advanced leprosy.The bandlike pattern of resorption may be seen with polyvinyl chloride exposure and Hadju-Cheney syndrome.A mnemonic commonly used for acro-osteolysis is PINCHFO.Pyknodysostosis, Psoriasis,
Injury (thermal burn, frostbite),
Neuropathy (diabetes),
Collagen vascular disease (scleroderma, Raynauds),
Hyperparathyroidism,
Familial (Hadju-Cheney, progeria), 
Occupational (polyvinyl exposure),
Acroosteolysis may be associated with minimal skin changes or with ischemic skin lesions that may result in digital necrosis. : 665

See also
Nail anatomy


== References ==