Muehrcke's lines

Muehrcke's lines

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Muehrcke's lines, or leukonychia striata, are changes in the fingernail that may be a sign of an underlying medical disorder or condition.

Common causes

The appearance of Meuhrcke's lines is nonspecific, but they are often associated with decreased protein synthesis, which may occur during periods of metabolic stress (e.g., after chemotherapy) and in hypoalbuminemic states such as the nephrotic syndrome.

An example of Muehrcke's Lines in the context of chemotherapy was published in the New England Journal of Medicine in 2007.

Complete Differential Diagnosis of the Causes of Muehrke's Lines (alphabetical):

• Chemotherapy
• Nephrotic syndrome

Complete Differential Diagnosis of the Causes of Muehrke's Lines (by organ system):

Cardiovascular	No underlying causes
Chemical / poisoning	Chemotherapy
Dermatologic	No underlying causes
Drug Side Effect	Chemotherapy
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	Chemotherapy
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	Nephrotic syndrome
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Physical examination

Muehrcke's lines are white lines that extend all the way across the nail and lie parallel to the lunula (half moon). In contrast to Beau's lines, they are not grooved. The lines are actually in the vascular nail bed underneath the nail plate, and as such, they do not move with nail growth. Meuhrcke's lines disappear when pressure is placed over the nail, blanching the underlying nail bed.

See also

• Mees' lines
• Beau's lines

External Resources

• Fawcett, Robert S. (March 15, 2004). "Nail Abnormalities: Clues to Systemic Disease". American Family Physician. 69 (6): 1417. PMID 15053406.