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Tuesday, 7 April 2015

Transverse lines : Informative physical signs

Nails are rich in physcial signs that may help making a clinical diagnosis.
It's important not to ignore careful inspection of nails during physical examination.
Some of the common nail signs are well known to medical students, like leukonychia, koilonychia, or splinter hemorrhages.
But some are less frequent and easily missed.

Transverse lines are an example of these signs.

The 3 important transverse lines are:

1- Beau’s lines:
  • Transverse linear depressions in the nail platte
  • Causes : Any severe illness or trauma

2- Mees’ lines: 
  • Transverse white bands in the nail plate
  • Cause : arsenic poisoning

3- Muehrcke’s lines:
  • Pairs of transverse white lines
  • They differ from the  Beau’s and Mees’ lines in their location;  Muehrcke’s lines are nail bed rather than nail plate lesions and they are vascular abnormality   
  • Cause : Hypoalbuminemia

Beau’s lines and Mees’ lines move distally by 1 mm every 10 days, while  Muehrcke’s lines do not

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