Question:

A 73 year-old man presented with a transverse depression on all finger nails. He had a history of diabetes mellitus, hypertension and renal impairment. Four months ago, he was admitted to hospital for fever, generalised skin rash and oral ulcers after taking allopurinol. He was managed conservatively and was discharged three months later. Apart from the nail deformity, he was also noted to have asteatotic eczema over the limbs and seborrheic dermatitis over the scalp.

Answer: B. Beau's lines

This patient had Beau's lines.

Beau's lines are transverse depressions in nail plates caused by a temporary slowing of nail growth. The underlying cause can be any severe systemic disturbance such as severe infection, high fever, severe drug eruption, etc. Beau's lines commonly affect more than one nail and appear simultaneously. Spontaneous recovery is expected if there is no subsequent systemic insult.