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

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 regarded2,11,12,15as 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. Report of Cases Case 1 (March, 1962). —A 22-year-old farm worker had been