Half and half nails (also known as "Lindsay's nails") show the proximal portion of the nail white and the distal half red, pink, or brown, with a sharp line of demarcation between the two halves.[1]: 785 The darker distal discoloration does not fade on pressure,[2] which differentiates Lindsay's nails from Terry's nails. The discoloration is thought to be due to β-melanocyte–stimulating hormone.[2] Seventy percent of hemodialysis patients and 56% of renal transplant patients have at least one type of nail abnormality. Absence of lunula, splinter hemorrhage, and half and half nails were significantly more common in hemodialysis patients, while leukonychia was significantly more common in transplant patients.[1]: 785 [3]: 659
| Half and half nails | |
|---|---|
| Other names | Lindsay's nails |
 | |
| Half and half nails | |
| Specialty | Internal medicine, Dermatology |
| Causes | increased β-MSH |
| Risk factors | hemodialysis, renal transplant |
| Diagnostic method | Physical examination |
| Differential diagnosis | Terry's nails |
Signs and symptoms
editHalf and half nail is when the distal portion of the nail is reddish brown, while the proximal area is white.[4]
Causes
editHalf and half nail is seen in 15-50% of chronic renal failure patients. It has also been associated with yellow nail syndrome, hyperthyroidism, pellagra, HIV infection, Crohn's disease, Kawasaki's disease, Behcet's disease, cirrhosis, and even in healthy individuals.[4]
Treatment
editAs the symptom itself is benign from the medical point of view, treatment is limited to cosmetic measures.[4]
See also
editReferences
edit- ^ a b James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
- ^ a b Pitukweerakul, Siwadon; Pilla, Sree (2016-08-01). "Terry's Nails and Lindsay's Nails: Two Nail Abnormalities in Chronic Systemic Diseases". Journal of General Internal Medicine. 31 (8): 970–970. doi:10.1007/s11606-016-3628-z. ISSN 1525-1497. PMC 4945547. PMID 26902238.
- ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
- ^ a b c Avhad, Ganesh; Ghuge, Priyanka (2014). "Half and half nail". Indian Dermatology Online Journal. 5 (5). Medknow: 67. doi:10.4103/2229-5178.144553. ISSN 2229-5178. PMC 4252964.
Further reading
edit- Aouali, Soraya; Sefraoui, Saida; Zizi, Nada; Dikhaye, Siham (2021). "Half and half nail, is it a marker of severe COVID-19 infection?". Annals of Medicine and Surgery. 71. Ovid Technologies (Wolters Kluwer Health): 102963. doi:10.1016/j.amsu.2021.102963. ISSN 2049-0801. PMC 8519785.
- Huang, W.-T.; Wu, C.-C. (2009-03-17). "Half-and-half nail". Canadian Medical Association Journal. 180 (6). CMA Joule Inc.: 687–687. doi:10.1503/cmaj.081312. ISSN 0820-3946. PMC 2653574.