MEES' LINES (or TRANSVERSE LEUKONYCHIA)
By Gary M. White, MD
Mees' lines are transverse white lines of the nail that are arcuate in the same shape as the lunula. They represent a toxic insult to the growth of the nail and are analogous to Beau's lines. They grow distally as the nail grows out.
- Make sure patient is not being poisoned with arsenic!!
- Heavy metal poisoning (e.g., from arsenic, thallium or lead), chemotherapy, infection, and cyclosporin [BJD 1999;140;1169] are potential causes.
- Mees' are different from Muehrcke's lines which are in the nail bed and do not grow out with the nail.
Determining and removing the insult is necessary. No specific treatment is in order. The changes will resolve as the nail grows out.
Mees' lines related to chemotherapy. TheScientificWorld Journal 2011;11;267-268
From arsenic. Postgrad Med J. 2006 Aug; 82(970): 515
From selenium toxicity along with diffuse alopecia. JAAD July 2010 Volume 63, Issue 1, Pages 168–169
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