Beau's lines following hand trauma

Abstract

Six cases are described of Beau's lines (transverse grooves in the fingernails) developing after injuries to the hand involving damage to nerves and flexor tendons. The literature is reviewed.

Bilateral Beau’s Lines and Pyogenic Granulomas following Guillain-Barré Syndrome

“…Tosti et al [7] postulated that nerve injury could produce these nail abnormalities. Ward et al [2] and Harford et al [3] however proposed that nerve lesions do not account for the appearance of Beau's lines since they did not always correlate. Furthermore, neither Beau's lines nor pyogenic granuloma were described in 679 patients suffering from denervation as a result of spinal cord injury [8].…”

“…The role of immobilization of the limb in the pathogenesis of Beau's lines and pyogenic granuloma is currently unknown but was reported in almost all the cases in the literature, including ours [2][3][4]7]. Dawber [9] has suggested that immobilization could slow down the fingernail growth rate.…”

“…Beau's lines are usually bilateral, but a few unilateral cases have been reported following injury to the affected hand. Ward et al [2] reported 6 patients with unilateral Beau's lines and nerves and flexor tendon lesions. Harford et al [3] reported an additional case with a homolateral fractured and immobilized wrist without nerve or flexor injury.…”

Transverse Nail Ridgings (Beau’s Lines) Induced by Chemotherapy

“…They appear several weeks after the nail dam age. Beau's lines have been described in patients with me tabolic disturbances, such as zinc deficiency in liver cirrho sis [9], various systemic diseases including diabetes melli tus [10], following hand injuries accompanied by damage of nerves and tendons [11], and even in infants soon after birth, due most probably to intrauterine damage [8]. En docrine disorders, other than diabetes, also have been sug gested as a possible cause.…”

Unilateral Beau's Lines Associatd with a Fingertip Crushing Injury

“…Although they are usually bilateral, unilateral (one hand or foot) Beau's lines may uncommonly occur. Unilateral Beau's lines have been described by Ward (1), Roberts (2), Price (3), and Harford (4) following injury of the wrist, hands, forearm, and elbow. Because their injured areas were the proximal portions of the nail folds, transverse depressions of the nails could occur in all the fingernails of the affected extremity.…”