| Half and half nails | |
|---|---|
| Other names | Lindsay's nails |
 | |
| Half and half nails | |
| Specialty | Internal medicine,Dermatology |
| Causes | increasedβ-MSH |
| Risk factors | hemodialysis, renal transplant |
| Diagnostic method | Physical examination |
| Differential diagnosis | Terry's nails |
Half and half nails (also known as "Lindsay's nails") show theproximal portion of thenail white and thedistal half red, pink, or brown, with a sharp line of demarcation between the two halves.[1]: 785 The darker distal discoloration does not fade on pressure,[2] which differentiates Lindsay's nails fromTerry's nails. The discoloration is thought to be due toβ-melanocyte–stimulating hormone.[2] Seventy percent ofhemodialysis patients and 56% of renal transplant patients have at least one type of nail abnormality. Absence oflunula, splinter hemorrhage, and half and half nails were significantly more common in hemodialysis patients, while leukonychia was significantly more common in transplant patients.[1]: 785 [3]: 659
Half and half nail is when the distal portion of the nail is reddish brown, while the proximal area is white.[4]
Half and half nail is seen in 15-50% of chronicrenal failure patients. It has also been associated withyellow nail syndrome,hyperthyroidism,pellagra,HIV infection,Crohn's disease,Kawasaki's disease,Behcet's disease,cirrhosis, and even in healthy individuals.[4]
As the symptom itself is benign from the medical point of view, treatment is limited to cosmetic measures.[4]