Unilateral Beau's Lines in Childhood Reflex Sympathetic Dystrophy

Abstract

Reflex sympathetic dystrophy is characterized by severe pain and autonomic dysfunction in a limb, usually after an injury. We describe a patient with childhood reflex sympathetic dystrophy with unilateral Beau's lines on the nails of the affected hand. Unilateral Beau's lines have not been described previously in this condition to our knowledge, and we discuss their possible pathogenesis.

Unilateral Beau′s lines in a case of complex regional pain syndrome (reflex sympathetic dystrophy)

“…Carcinomas, infections, trauma, iatrogenic, ischemic, neurologic, and arthritic events may give rise to RSD. [4] In 10-26% patients with RSD, no inciting factor can be found as in our case. [5] There are various concepts to explain the etiopathogenesis of RSD.…”

“…[2] Some nail findings have been reported in patients with RSD. [4] We present the second case of RSD associated with unilateral Beau's line.…”

Bilateral Beau’s Lines and Pyogenic Granulomas following Guillain-Barré Syndrome

“…The role of immobilization of the limb in the pathogenesis of Beau's lines and pyogenic granuloma is currently unknown but was reported in almost all the cases in the literature, including ours [2][3][4]7]. Dawber [9] has suggested that immobilization could slow down the fingernail growth rate.…”

“…Harford et al [3] reported an additional case with a homolateral fractured and immobilized wrist without nerve or flexor injury. O'Toole et al [4] described a child with reflex sympathetic dystrophy who also presented with unilateral Beau's lines.…”

Unilateral trachyonychia in a patient with reflex sympathetic dystrophy

“…[3][4][5][6][7][8][9][10] Nail findings, such as leukonychia, Beau's lines, nailfold swelling, and clubbing, have been linked with RSD. [11][12][13][14] Trachyonychia refers to rough nails, often with longitudinal streaking, pitting, and ridging, which affect from 1 to 20 nail plates. 15 Affected nail plates are often brittle and can break with minimal trauma.…”