In 1846, Joseph Honoré Simon Beau (1806–1865)1 described the evolution of transverse grooves in the nail plate in typhoid fever and other systemic disorders. Conditions reported in association with these furrows, aptly called Beau lines, include severe systemic diseases, chemotherapy administration, drug ingestion, Kawasaki disease, renal failure, and infection. Onychomadesis, considered a more severe form of Beau lines, is defined as spontaneous separation of the nail plate from the nail bed beginning at the proximal end and resulting in shedding of the nail. There have been rare cases reported2- 5 of idiopathic onychomadesis not associated with any disease or drug therapy that presented in a familial autosomal dominant pattern. To our knowledge, the present case report describes only the second occurrence of idiopathic onychomadesis without familial inheritance.
Figure. Left thumbnail of patient showing onychomadesis.
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