Half and half nails (Lindsay's nails) in chronic renal disease.

A 19 year old male, student, presented with a history of progressive loss of vision from right eye since one and half year and from the left eye since one year. The patient also complained of multiple episodes of generalized seizures three months back. Patient was diagnosed with tubercular choroiditis with chronic kidney disease with seizure disorder. The patient was evaluated but no intracranial tuberculosis was found. Physical examination was unremarkable except for finger nails showing transverse distal red-brown band occupying most of the nail with a dull, white proximal band (half and half appearance) (Figure 1 and Figure 2). Cranial nerve examination revealed visual acuity in right to be PL and on left to be FC at 10 cm. Fundus showed hazy media. Remaining systemic evaluation was normal. Investigations revealed Hb-12.4 gm%, WBC-8000/dL, N-80%, L-15%, E-4%, M-1%; urea-52 md/ dL, creatinine-2.9 mg/dL, uric acid-9.7 mg/dL, Na-160 mmol/L, K-3.6 mmol/L, RBS-104 mg/dL; LFT: ALP-722 U/L. 24 hour urine protein70 mg/ day. USGHalf and Half Nails (Lindsay’s nails) in Chronic Renal Disease