half-and-half nails

Last reviewed 11/2022

Also known as Lindsay's nails, is commonly seen as a complication of uraemia (1).

In half and half nails the proximal portion on the nail bed is white (due to oedema of the nail bed and the capillary network) and the distal portion is pink or reddish brown with a sharp line of demarcation. Nail plate involvement is not seen (1)::

  • Lindsay found this to be related to patients with renal disease associated with azotemia (uremic patients)
    • may be seen in approximately 10% of patients with renal failure. The phenomenon disappears within 2-3 weeks of successful renal transplantation but is not influenced by dialysis
  • has also been reported in those taking systemic 5-fluorouracil (2), in hemodialysis patients, renal transplant recipients and in HIV patients (1)

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