Half-and-half nails

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)

Click here for an example image of this condition

Reference:

• (1) Gregoriou S et al. Nail disorders and systemic disease: What the nails tell us. JFP 2008; 57(8)
• (2) Zaiac MN, Daniel CR. Nails in systemic disease Dermatologic Therapy 2002;15 (2); 99-106
• (3) Baran B. Nail Disorders. Medicine International 1992; 102; 4309.