A 55-year-old man being evaluated for chronic liver disease has white nail beds with a narrow band of normal pink colour at the distal edge of all fingernails. The abnormality does not fade with pressure and does not move distally with nail growth. This finding is classically associated with:

• A Cirrhosis ✓
• B Chronic renal failure
• C Arsenic poisoning
• D Congestive cardiac failure

Explanation

Terry nails, apparent leukonychia with an opaque white plate sparing a distal pink to brown band of about 0.5 to 3 mm, is classically linked to cirrhosis and hypoalbuminaemia. Lindsay half-and-half nails, with the proximal half white and distal half reddish brown, belong to uraemia. Mees lines are transverse white bands that move distally with growth and suggest arsenic or heavy metal exposure.

Reference: Rook's Textbook of Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.