What causes Lindsay's nails (leukonychia)?

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From the Research

Lindsay nails are primarily caused by chronic kidney disease (CKD), and their presence can be a valuable clue to underlying renal impairment, particularly in patients with risk factors for CKD 1. The condition is characterized by a white proximal half and a reddish-brown distal half of the nail plate. This nail condition occurs due to the buildup of nitrogenous waste products in the blood, which affects nail bed vasculature and keratin production. Some key points to consider about Lindsay nails include:

  • They can also be associated with other conditions such as cirrhosis of the liver, Kawasaki disease, Crohn's disease, pellagra, and certain medications like chemotherapy drugs 2.
  • The presence of Lindsay nails in a patient with a risk factor for CKD could indicate long-standing renal impairment, even when serum creatinine levels are not available 1.
  • Treatment focuses on addressing the underlying condition rather than the nail appearance itself, and for patients with CKD, this typically involves proper management of kidney disease through medication, dialysis, or potentially kidney transplantation 2.
  • The nail changes may improve as kidney function stabilizes or improves with appropriate treatment 2. It is essential to seek medical evaluation if Lindsay nails are noticed, as they may indicate serious underlying kidney dysfunction 1.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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