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