Indentation across fingernails
A 46-year-old woman went to see her family physician (FP) because she was concerned about the transverse indentation across her fingernails. She said that she’d had a laparoscopic cholecystectomy 2 months earlier, and had recovered well. She also indicated that she was working on lifestyle changes in an effort to lose weight and avoid diabetes.
What's your diagnosis?
The FP recognized the nail condition as Beau's lines. Given that fingernails grow approximately 2 to 3 mm per month, the physiologic stressor causing the Beau’s lines was likely the cholecystitis and cholecystectomy 2 months earlier. The physician reassured the patient that the lines would grow out and likely be gone by 4 months, at the latest.
The FP also used the visit as an opportunity to reinforce the importance of a good diet, exercise, and weight loss for the patient's general health.
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photo courtesy of Suraj Reddy, MD. This case was adapted from: Mayeaux EJ. Normal nail variants. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:819-821.
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