What’s the Cause of These Nail Findings?

April 30, 2014

A patient is transferred out of the intensive care unit after a 3-week course of sepsis. You are asked to identify and explain why his nails have these lesions. The patient has never noticed them before. Do you know what these are called and their cause?(Answer below)

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This patient has Beau’s lines. They are usually caused by severe stress to the body. This includes severe septic shock, heart attack with hypotension, major surgeries, malnutrition and certain types of chemotherapy. Using the fact that nails grow at a rate of approximately 1mm per week, you can roughly figure out the time of the stressful event by measuring how far out the line is.

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