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April 1972

The ``Half-and-Half Nail"A Uremic Onychopathy

Author Affiliations


From the Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia. Dr. Leyden is a postdoctoral trainee supported by Public Health Service research grant TI AM 05261.

Arch Dermatol. 1972;105(4):591-592. doi:10.1001/archderm.1972.01620070063024

A 55-year-old patient had chronic renal failure and pigmentary nail changes. The distal nail appeared dark brown while the proximal nail was white. This nail pattern has been previously called the ``half-and-half nail" and is believed to be a nail pattern uniquely found in certain patients with chronic renal failure. A biopsy showed the pigment to be melanin. Stimulation of matrix melanocytes during sudden renal decompensation is proposed as the cause of this nail finding.