RESUMO
Transverse leukonychia (Leukonychia striata or Muehrcke's lines) has been described with the use of several drugs in oncology, mainly chemotherapeutic agents. This condition is thought to represent an abnormality of the vascular nail bed. As the diagnosis is clinical and the condition is self-limited, referral to other specialists is usually not required. We report the first case of transverse leukonychia related to the use of transretinoic acid for acute promyelocytic leukemia. Physician awareness of transverse leukonychia is important in order to reassure the patients and avoid unnecessary (and often not inexpensive) diagnostic work-up.
Assuntos
Antineoplásicos/efeitos adversos , Leucemia Promielocítica Aguda/tratamento farmacológico , Doenças da Unha/induzido quimicamente , Tretinoína/efeitos adversos , Idoso , Antineoplásicos/uso terapêutico , Feminino , Humanos , Doenças da Unha/diagnóstico , Doenças da Unha/patologia , Tretinoína/uso terapêuticoRESUMO
Transverse leukonychia, also termed leukonychia striata, usually occurs in association with trauma, nutritional deficiencies, exposure to toxin, and various combinations of chemotherapy. It also has been reported to be associated with various systemic diseases, including acute infection, myocardial infarction, lymphoma, hepatic failure, renal failure, and systemic lupus erythematosus. A 50-year-old woman with several months' history of nail changes presented with multiple discrete transverse white bands involving the entire width of the nail plates of her fingers. According to the patient's medical history, she had experienced fatigue, constipation, and cold intolerance for 6 months, and antithyroid antibodies were detected before noticing these nail changes. The patient was diagnosed as having an autoimmune hypothyroidism. Repeated KOH microscopic examination did not demonstrate fungal infection. We diagnosed this case as transverse leukonychia associated with hypothyroidism. This case report underlines the possible association of transverse leukonychia with hypothyroidism.