By Gary M. White, MD

Muehrcke's lines

Muehrcke's lines are transverse, curved white lines of the nail related to changes in the nail bed. They do not grow out with the nail, in contrast to Mees' lines. Edema of the underlying connective tissue seems to be the cause. They are most commonly associated with hypoalbuminemia (e.g., nephrotic syndrome) but may occur after trauma and periods of metabolic stress (e.g., chemotherapy).


Transverse, curved white lines alternating with flesh-colored lines are characteristic. They disappear when pressure is placed over the nail, blanching the underlying nail bed.


These changes reverse when the edema resolves or the albumin is restored to normal.


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