Which nail finding is classically associated with arsenic poisoning?

• A. Mees lines (Aldrich-Mees lines)
• B. Beau’s lines
• C. Muehrcke’s lines
• D. Lindsay’s lines

Answer: (A)

Nail changes testify to a temporary disruption of nail matrix growth after toxin exposure, and the classic sign tied to arsenic poisoning is Aldrich-Mees lines. These are white transverse bands that run across the nail plate and form when arsenic temporarily impairs nail formation. They typically appear weeks after exposure and grow out with the nail, so you’ll see them on several nails if exposure was systemic.

Other nail findings point to different problems: Beau’s lines are grooves or depressions in the nail from systemic stress or illness; Muehrcke’s lines are paired white lines related to hypoalbuminemia and reflect the nail bed more than the matrix; Lindsay’s nails refer to half-and-half nails often seen in chronic kidney disease. So when you encounter these white transverse bands across the nail, the association most classically linked to arsenic exposure is Aldrich-Mees lines.