Thursday, July 10, 2008

Beau's line

I have stressed this to medical student before that nails are very important and in fact you can come to a diagnosis based on nails.
This is one of my patient in the haematology ward who came for chemotherapy for ALL(Acute lymphoblastic leukaemia).

The above shows Beau's line which is due to temporary arrest of nail growth from chemotherapy agent for the haematological malignancy.

Review from

Nail Findings and Associated Systemic Conditions
Nail finding
Associated systemic conditions
Shape or growth change
Clubbing Inflammatory bowel disease, pulmonary malignancy, asbestosis, chronic bronchitis, COPD, cirrhosis, congenital heart disease, endocarditis, atrioventricular malformations, fistulas
Koilonychia Iron deficiency anemia, hemochromatosis, Raynaud's disease, SLE, trauma, nail-patella syndrome
Onycholysis Psoriasis, infection, hyperthyroidism, sarcoidosis, trauma, amyloidosis, connective tissue disorders
Pitting Psoriasis, Reiter's syndrome, incontinentia pigmenti, alopecia areata
Beau's lines Any severe systemic illness that disrupts nail growth, Raynaud's disease, pemphigus, trauma
Yellow nail Lymphedema, pleural effusion, immunodeficiency, bronchiectasis, sinusitis, rheumatoid arthritis, nephrotic syndrome, thyroiditis, tuberculosis, Raynaud's disease
Color change
Terry's (white) nails Hepatic failure, cirrhosis, diabetes mellitus, CHF, hyperthyroidism, malnutrition
Azure lunula Hepatolenticular degeneration (Wilson's disease), silver poisoning, quinacrine therapy
Half-and-half nails Specific for renal failure
Muehrcke's lines Specific for hypoalbuminemia
Mees' lines Arsenic poisoning, Hodgkin's disease, CHF, leprosy, malaria, chemotherapy, carbon monoxide poisoning, other systemic insults
Dark longitudinal streaks Melanoma, benign nevus, chemical staining, normal variant in darkly pigmented people
Longitudinal striations Alopecia areata, vitiligo, atopic dermatitis, psoriasis
Splinter hemorrhage Subacute bacterial endocarditis, SLE, rheumatoid arthritis, antiphospholipid syndrome, peptic ulcer disease, malignancies, oral contraceptive use, pregnancy, psoriasis, trauma
Telangiectasia Rheumatoid arthritis, SLE, dermatomyositis, scleroderma

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