Lindsay ’s nail

A 60-year-old man with diabetes and chronic kidney disease undergoing maintenance hemodialysis presented to our hospital with chronic nail changes that had been present for at least 2  years. He had not experienced any previous fingernail injuries. The nail examination showed the whiteness of the proximal portion of the nail bed and reddish-brown discoloration of the distal half of the nail bed in all his fingernails (Figure 1). The discoloration of the nails did not fade with pressure. On the basis of the clinical history, the patient was diagnosed as having Lindsay ’s nails. Although the pathophysiological mechanism of Lindsay’s nail is still unknown, the distal reddish-brown changes might be related to increased melanin deposition, caused by increased concentration ofβ-melanocyte-stimulating hormone. Lindsay ’s nail can be found in 20% of patients on renal replacement therapy1 (peritoneal dialysis, hemodialysis and renal transplantation). There is no specific therapy for Lindsay ’s nails but the discoloration sometimes disappears completely after successful renal transplantation.
Source: QJM - Category: Internal Medicine Source Type: research