 |
|
 |
|
|
|
May 2001
Case Submitted by Drs. LaDuca and Mercurio.
|
|
|
CASE:
A 15-year-old boy reports that his fingernails are shedding.
His medical history is significant for acute lymphocytic leukemia,
for which he underwent an allogeneic bone marrow transplant
two months earlier. Examination of the fingernails reveals
a transverse groove extending over the entire width of each
nail. On each finger, the distal nail is thin and loosely
attached to the nail bed.
|
| What is your diagnosis? |
| |
|
|
|
The patient's nails show Beau's lines, which
are transverse grooves in the nail plate that may be caused
by any of a number of systemic insults. The underlying mechanism
is a temporary suspension of cell division in the nail matrix.
Among the most frequent causes of Beau's lines are febrile illness,
zinc deficiency, and various drugs. When the transverse groove
is deep, distal nail shedding may occur, resulting in a condition
known as onychomadesis. Because normal nail growth occurs at
about 0.1 mm per day, it is possible to estimate the date of
the insult. |
Dr. LaDuca is a resident in dermatology and Dr. Mercurio
is assistant professor of dermatology at Strong Memorial Hospital
in Rochester, New York.
|
|
