Transverse White Lines in the Fingernails After Acute and Chronic Renal Failure

Abstract

WHITE transverse lines affecting the fingernails, although classically associated with arsenical poisoning (Mees' lines),^1-3have been noted after a variety of systemic illnesses, including: thallium toxicity, leprosy, malaria, fluorosis, psoriasis, cardiac insufficiency,⁴pellagra,⁵Hodgkin's disease,⁶pneumonia,⁷myocardial infarction,⁸sickle-cell anemia⁹and infectious fevers (Reil's lines).^10-13It has been pointed out¹⁴that it is probably the acute and serious nature of the underlying illness which provokes the formation of such white transverse bands, presumably through a nonspecific effect on nail growth, and in this sense they are often regarded^2,11,12,15as the equivalent of Beau's lines,¹⁶or transverse grooves, which have been described after a similarly varied group of illnesses.¹⁷ It is the purpose of this paper to record the appearance of white transverse lines in the fingernails of six patients after treatment of acute and chronic renal failure. <h3>Report of Cases</h3><h3>Case 1 (March, 1962).</h3> —A 22-year-old farm worker had been