Transverse leukonychia: a case report

A case of transverse leukonychia following chemotherapy for Hodgkin's disease in a 17-year-old white male is reported. The patient presented with multiple white bands across the fingernails, which appeared three weeks after the end of chemotherapy. The changes were almost homogeneously spread across the breadth of the fingernail plates, showing smooth borders with a rounded distal edge. Because of Hodgkin's disease in Costwold stage IE, he received sequential chemotherapy with cyclophosphamide, adriamycin, procarbazine, prednisolone, vincristine and bleomycine, and mediastinal mass irradiation. The authors emphasize that white transverse nail banding - Leukonychia striata or Muehrcke lines - constitute an aesthetical unpleasant side-effect of medication, but may represent an easily observed sign indicative of previous use of cytotoxic therapy for malignancy.