A 70-year-old man with hormone-refractory prostate cancer who had been treated with three cycles of doc-etaxel and prednisone chemotherapy presented with three evenly spaced, transverse lines on all of his nails (Fig. 1). Diagnosis of transverse ridging of the nails, also known as Beau's lines, was made.Beau's lines are typical signs of acute toxicity to the nail matrix keratinocytes with transient arrest in the nail plate production. The nail shows a transverse depression that migrates distally as the nail grows. These nail abnormalities are not exclusive to drugs, but are commonly seen after trauma or systemic illness.
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