Case report showed Muehrcke's nails, not Beau's lines

BMJ 2003; 326 doi: http://dx.doi.org/10.1136/bmj.326.7380.105/a (Published 11 January 2003) Cite this as: BMJ 2003;326:105
  1. Matthias Möhrenschlager, professor (m.moehrenschlager{at}lrz.tum.de),
  2. Dietrich Abeck, professor of dermatology,
  3. Johannes Ring, professor of dermatology
  1. Department of Dermatology and Allergy Biederstein, Technical University of Munich, D-80802 Munich, Germany

    EDITOR—The patient in the case presented by Moule et al in Minerva had several narrow transverse white bands on her nail plates after receiving five cycles of combined chemotherapy for non-Hodgkin's lymphoma.1 We studied the clinical photograph thoroughly. We did not detect any transverse grooves or furrows on the nail plate, which are characteristic of Beau's lines.2 In contrast, the band-like ungual discolorations resemble closely the clinical manifestations of leukonychia striata, or Muehrcke's nails.

    Leukonychia is a common finding in nails of fingers and toes.3 Grossman and Scher listed over 70 different causes of this nail plate discoloration.4 Apart from conditions of chronic hypoalbuminaemia, Muehrcke's nails can develop after the use of chemotherapeutic agents.2 5 These abnormalities are due to incomplete keratinisation, so that nuclei or nuclear debris are retained in the nail plate.2 In contrast, Beau's lines are due to temporary interference with nail plate formation and become visible on the proximal nail surface as a transverse depression some weeks after administration of the drug.2


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