Beau's lines; Mee's lines; onychomadesis

Introduction

Horizontal depressions across the nail plate secondary to a transient arrest in nail growth.

Etiology

temporary arrest of nail growth can result from

• acute stress or illness, such as:
  • circulatory shock
  • myocardial infarction
  • pulmonary embolism
  • high fever
  • toxic epidermal necrolysis, erythroderma, scarlet fever
  • surgery
  • cold tempertature
• drugs may also cause formation of Beau's lines
  • chemotherapy or immunosuppressive agents in particular
• severe zinc deficiency (proposed as cause)
• because nail & hair growth are under the same influences, Beau's lines & telogen effluvium often occur together
• Mee's lines are white bands associated with
  • arsenic poisoning
  • carbon monoxide poisoning
  • Hodgkin's disease
  • malaria
  • leprosy

Pathology

• onychomadesis is a painless spontaneous periodic separation of the nail plate from the bed, beginning at the proximal end with subsequent shedding of the nail as the new nail grows
• onychomadesis occurs as a result of temporary arrest of nail growth at the nail matrix, the cause of Beau's lines

Clinical manifestations

• Beau's lines are transverse furrows beginning in the nail matrix
• Mee's lines are transverse white lines in the nail
• timing of the disease or event can be determined by the location of the lines on the nail

* images

Notes

• from the age of the patient & position of the line, it is possible to identify the time of the stressful event

More general terms

• nail disease

Additional terms

• nail plate