Images in Internal Medicine
Received: 25 October 2020
Accepted: 19 May 2021
A 33-year-old male healthcare worker in an intensive care unit had horizontal grooves on all his nails. These grooves were 4 mm from the proximal nail fold (Figure 1). Four months ago, in the course of his work, he developed a fever, cough, diarrhea, arthralgia and hyposmia for eight days, but did not require hospitalization. He was ultimately diagnosed with COVID-19 through a positive nose swab PCR test. He had no traumas or other concurrent febrile disease.
Figure 1
Beau lines: Horizontal grooves (arrows) 4 mm from the proximal nail folds.
Beau lines are caused by a temporary interruption of the growth of the proximal nail matrix 1. They generally occur after episodes of cardiac arrest, chemotherapeutic agents, febrile illnesses, trauma and Raynaud's disease 2. Since the beginning of the COVID-19 pandemic, reported dermatological findings have included maculopapular, vesicular and urticarial rashes 3. This image is an invitation to actively seek a new spectrum of COVID-19 manifestations.
References
1. Jandial A, Mishra K, Prakash G, & Malhotra P. (2018). Beau's lines. Case Reports, 2018, bcr-2018.
2. Piraccini BM & Iorizzo M. (2007). Drug reactions affecting the nail unit: diagnosis and management. Dermatologic clinics, 25(2), 215-221.
3. Daneshgaran, G, Dubin, DP, & Gould, DJ. (2020). Cutaneous Manifestations of COVID-19: A Systematic Review.
Author notes
*Correspondencia: Dr. Ángel Rolando Galván Marín. Bogotá (Colombia). E-Mail: agalvanmed@hotmail.com
