Muehrcke’s nails, lines or leukonychia striata are paired, white, transverse lines that signify an abnormality in the vascular bed of the nail. Muehrcke’s lines were described by Robert C. Muehrcke in 1956.


The appearance of the paired, narrow, white bands on the fingernails is typically correlated with a serum albumin level below 2.2 g/100 mL.

Most common causes:

  1. Hypoalbunimaea
  2. Chemotherapy
  3. Nephrotic Syndrome

Differential Diagnosis:

  • Angiokeratoma Corporis Diffusum (aka Fabry Syndrome)
  • Onycholysis
  • Paronychia
  • Psoriasis, Nails


Treatment should be undertaken in a case-specific manner with the main goal of treatment to increase the protein levels above 2.2 g/100 mL.