Transverse striate leukonychia (Mees' lines) can occur with a variety of acute or chronic diseases. They may arise as a result of disruption of nail plate keratinization secondary to systemic stress

Mees' lines consist of a white, transverse band that migrates as the nail grows. Repeated exposures can cause more than one band being present. All or most nails should be affected.


Risk factors associated with toxic exposures:

(1) chemotherapy

(2) arsenic poisoning

(3) carbon monoxide poisoning

(4) thallium poisoning


Risk factors associated with systemic disease:

(1) heart failure

(2) renal failure

(3) sickle cell disease

(4) Hodgkin's disease

(5) psoriasis

(6) parasitic infection

(7) pneumonia


Differential diagnosis:

(1) Terry's nails.

(2) Muehrcke lines

(3) Beau's lines

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