Unilateral Beau's Lines Associatd with a Fingertip Crushing Injury

Abstract

Beau's lines are transverse depressions or ridgings of the nail surface that are the result of the temporary arrest of nail matrix formation. They are caused by systemic diseases, local trauma, drugs, and infection. Generally, Beau's lines after a fingertip injury occur on only the affected finger, not on the unilateral extremity. In this report, we present the case of a 36-year-old man who developed transverse ridgings in the nail plates of all five fingers of the affected extremity after a fingertip (thumb) crushing injury. During the follow up, the growth rate of affected fingernails was normal. The transverse ridgings advanced with the linear growth of the nails and eventually disappeared. To the best of our knowledge, no association between unilateral Beau's lines and fingertip injury has been reported in the English literature.

Unilateral Beau's lines associated with a fractured olecranon

“…Beau's lines have been attributed to temporary arrest in nail plate growth at the nail matrix following a physiological insult 1,5 . It has been postulated that Beau's lines may result from interference with the blood supply and metabolism of the proximal matrix of the nail 1,5 . The Beau's lines in this patient may have resulted from a temporary reduction in blood supply of the nail matrix secondary to the olecranon fracture.…”

“…In most individuals, fingernails grow at 0.1 mm per day and toenails at 0.03 mm per day. The distance between the Beau's line and the nail fold can assist in calculating the time from causative physiological insult or the duration of illness 3,5 . The angle of the transverse depression has been suggested to reflect the severity of the insult with a shallow gradient suggesting a gradual onset and a steep gradient suggesting a rapid onset 3,6 …”

“…The pathogenesis of Beau's lines is not clearly understood. Beau's lines have been attributed to temporary arrest in nail plate growth at the nail matrix following a physiological insult 1,5 . It has been postulated that Beau's lines may result from interference with the blood supply and metabolism of the proximal matrix of the nail 1,5 .…”

A review of practical issues related to the diseases of the nail unit useful for doctors (including non-dermatologists)

“…(3,8,9) . Lee and Yun shared a very interesting observation on the relationship between wearing a sling and the occurrence of Beau's lines (10) . Washboard nails are the result of habitual irritation (pushing away, pressing, etc.)…”

Líneas de Beau secundarias a enfermedad aguda en una mujer anciana

“…Aunque se desconoce el mecanismo exacto para la génesis de las líneas de Beau, se considera que su presencia refleja un cese temporal de la actividad mitótica en la matriz proximal de la uña, por disminución del flujo sanguíneo y el metabolismo (4). Lo anterior puede estar ocasionado por enfermedades sistémicas y febriles agudas, falla renal, síndrome de Stevens-Johnson, desnutrición, pénfigo, agentes quimioterapéuticos contra el cáncer y exposición al frío extremo en pacientes con enfermedad de Raynaud (4-6).…”