Beau's Lines: This patient received 4 cycles of docetaxel (taxotere) chemo spaced three weeks apart. The growth delay from the taxotere caused these transverse nail ridges, like growth rings in a tree. Beau's lines do not blanche with pressure on the nail, unlike Muehrcke's lines. After chemotherapy is completed, the damaged nails will grow out eventually. Until the nails grow back, its a good idea to protect damaged nails and cuticles with rubber or vinyl gloves when doing household cleaning. Nail ridge fillers can be used as a basecoat before applying polish can both protect the nails and improve their appearance.
Treatment Of Actinic Keratosis and Basal Call Carcinoma With Imiquimod (Aldara): From top to bottom: Top: Pre Aldara. The actinic keratosis is the scaly lesion on the right, the basal cell is the small ulcer at the left ala nasi.; Middle: The patient was on daily Aldara treatment for four weeks. She developed skin irritation and Aldara was stopped. The scaly areas are regions of subclinical actinic keratosis exposed by Aldara; Bottom: Two weeks later. Aldara caused selective desquamation of damaged skin, followed by complete healing.
Skin irritation from imiquimod is temporary but can be severe. Mild cases can be managed with topical Aquaphor. Severe skin reaction may require both topical xylocaine for pain relief, and 1% Silver Sulfadiazine Cream to promote healing and prevent infection.