The ``Half-and-Half Nail"

Abstract

A 55-year-old patient had chronic renal failure and pigmentary nail changes. The distal nail appeared dark brown while the proximal nail was white. This nail pattern has been previously called the ``half-and-half nail" and is believed to be a nail pattern uniquely found in certain patients with chronic renal failure. A biopsy showed the pigment to be melanin. Stimulation of matrix melanocytes during sudden renal decompensation is proposed as the cause of this nail finding.