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Muehrcke Lines of the Fingernails Workup

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Jun 22, 2016
 

Laboratory Studies

Obtain appropriate laboratory tests as indicated by the history features and the physical examination findings. The most important test is probably serum albumin measurements. Total serum protein levels, serum chemistry enzyme levels, a urine analysis, and a CBC count are also useful tests. In patients being treated for cancer, obtaining the blood levels of certain chemotherapeutic agents is probably important.

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Procedures

Certain studies, including nail composition studies; potassium hydroxide preparations; or biopsy with light microscope, electron microscope, or special staining, may be indicated.

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Histologic Findings

According to Nabai, histopathologic sections of the nail plates show compact orthokeratotic keratinous material in combination with areas suggesting some delay in keratinization. No definite evidence of parakeratotic change is present, and no evidence of distortion or thinning of the nail plates exists.[10] James and Odom[25] additionally suggested that the injury may lead to the development of parakeratotic or dyskeratotic foci within the nail matrix and retained in the nail plate; however, they were unable to show such histologic changes in their patient.

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Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

Channing R Barnett, MD Staff Physician, Department of Dermatology, University of Medicine and Dentistry of New Jersey

Channing R Barnett, MD is a member of the following medical societies: Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Richard K Scher, MD Adjunct Professor of Dermatology, University of North Carolina at Chapel Hill School of Medicine; Professor Emeritus of Dermatology, Columbia University College of Physicians and Surgeons

Richard K Scher, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American Medical Association, Association of Military Surgeons of the US, International Society for Dermatologic Surgery, Noah Worcester Dermatological Society, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

References
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White, transverse, horizontal lines are observed on 4 fingers of a 49-year-old man with adenocarcinoma in his rectosigmoid and adenoma in his sigmoid found in May 2002; he was treated with preoperative radiation and 4 continuous infusions of 5-fluorouracil at the same time.
Close-up view.
White transverse bands are seen on all 10 fingers.
Horizontal white bands are seen on all 10 fingernails.
Close-up view of 4 fingers. White horizontal bands are evident.
Close-up view. White horizontal bands are evident.
 
 
 
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