Mees' lines

Mees' lines (also known as Aldrich-Mees' lines) are a medical condition characterized by the appearance of transverse white lines on the nails. These lines are typically parallel to the lunula (the white crescent-shaped area at the base of the nail) and are a sign of systemic disease or exposure to certain toxins.

History

Mees' lines were first described by the Dutch physician R.A. Mees in 1919. He observed these lines in patients who had been exposed to arsenic and noted their association with systemic illness.

Causes

Mees' lines can be caused by a variety of factors, including:

• Arsenic poisoning
• Thallium poisoning
• Chemotherapy
• Renal failure
• Hodgkin's lymphoma
• Leprosy
• Malaria

Pathophysiology

The exact mechanism behind the formation of Mees' lines is not fully understood. However, it is believed that the lines form due to a temporary disruption in the normal growth of the nail matrix, which is the tissue under the base of the nail that produces new nail cells. This disruption can be caused by systemic illness or exposure to toxins, leading to the characteristic white lines.

Diagnosis

Diagnosis of Mees' lines is primarily clinical, based on the appearance of the nails. A thorough medical history and physical examination are essential to identify any underlying systemic conditions or exposure to toxins. Additional tests may be required to confirm the diagnosis, such as:

• Blood tests to check for toxins or underlying diseases
• Urine tests
• Biopsy of the nail matrix (rarely needed)

Treatment

Treatment of Mees' lines involves addressing the underlying cause. Once the systemic illness or toxin exposure is managed, the lines will gradually grow out with the nail. In some cases, supportive care may be necessary to manage symptoms associated with the underlying condition.

Prognosis

The prognosis for individuals with Mees' lines depends on the underlying cause. If the cause is identified and treated promptly, the lines will eventually disappear as the nail grows out. However, if the underlying condition is severe or chronic, the prognosis may be more guarded.

See also

• Nail (anatomy)
• Arsenic poisoning
• Thallium poisoning
• Chemotherapy
• Renal failure
• Hodgkin's lymphoma
• Leprosy
• Malaria