Mees' lines
Enable an agent to recognise, document and follow suspected Mees' lines while keeping the observed nail sign separate from any inferred underlying cause.
Bundle → Layer → Finding → Questions Filled
5 bundles · 9 layers · 12 findings · 22 questions
Recognition and name boundary Establish what appearance is being labelled Mees' lines and which naming convention is being used.
Transverse band identification
Describe the visible pattern before interpreting its origin.
Candidate white bands
Record colour, transverse orientation, continuity and relationship to the lunula for each candidate band.
- Are the white areas transverse bands rather than spots, longitudinal streaks or diffuse whitening? definition
- What are each band's width, continuity and transverse coverage on the affected nail? measurement
Eponym usage
Expose differences in the scope of the name rather than forcing all transverse leukonychia into one usage.
Declared naming convention
Retain the source's usage: DermNet equates striate leukonychia with Mees' lines, while a specialist review distinguishes trauma-induced transverse true leukonychia in its terminology. [DermNet](https://dermnetnz.org/topics/white-nail), [Leukonychia review](https://pmc.ncbi.nlm.nih.gov/articles/PMC8809498/)
- Which clinical reference or examiner supplied the Mees' lines label? provenance
- Does that source include locally traumatic transverse leukonychia within the eponym? boundary
Plate localisation and mimics Test whether the whitening belongs to the nail plate and document competing nail findings.
Pressure and growth tests
Combine examination and follow-up evidence about anatomical localisation.
Plate localisation evidence
Record pressure response and serial displacement separately, including unperformed or inconclusive tests.
- Does the band remain visible when pressure is applied during examination? measurement
- Does a recognisably identical band move distally between dated observations? measurement
Contour and surface assessment
Assess structural grooves, superficial whitening and mixed appearances.
Alternative or coexisting signs
Document whether a groove, surface alteration or other whitening pattern better explains the observation or occurs alongside it.
- Is the transverse feature a colour band, a palpable depression, or both? boundary
- What examination evidence distinguishes intrinsic whitening from superficial scale, a coating or another nail disorder? boundary
Distribution and band history Capture which nails are involved and how individual bands change over time.
Nail-by-nail pattern
Compare band burden and placement across explicitly examined digits.
Mapped involvement
Maintain a digit map with band counts, positions and examination completeness.
- Which fingernails and toenails were examined, and which contain candidate bands? measurement
- Are band number and placement similar across nails, or is involvement restricted to particular digits? measurement
Serial band tracking
Track matched bands without treating their position as an exact exposure date.
Qualified growth timeline
Separate directly observed displacement from any inferred formation interval and document the growth assumptions used.
- What dated measurements establish displacement of the same band using the same anatomical landmark? measurement
- If formation timing is estimated, what nail-specific growth evidence and uncertainty support the interval? provenance
Causal interpretation and review Connect the nail sign to relevant history while preserving uncertainty and actionable review needs.
Trigger evidence
Assess documented candidate events against the observed nail pattern and timing.
Supported trigger hypotheses
Record candidate exposures and treatments separately from causal conclusions; reported associations include heavy metals and chemotherapy. [DermNet: White nail](https://dermnetnz.org/topics/white-nail)
- Which exposure, treatment, illness or local injury is documented, and by what record? provenance
- What evidence supports or contradicts its temporal and anatomical fit with the bands? boundary
- What independent clinical evidence would be needed before attributing the bands to that candidate? action
Review and reassessment
Turn incomplete identification into a defined clinical review or observation task.
Evidence-linked next step
Specify the missing examination, history or follow-up observation and record how its result changes the interpretation.
- What clinical review is warranted by the person's exposure history and accompanying symptoms? action
- What follow-up observation would strengthen the identification or require reclassification? action
- Have existing bands grown out, new bands appeared, or observation ended before their course could be established? measurement
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Check these first
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these check these first hold for the sense of Mees' lines this model covers, and on what evidence? provenance
Real-world use
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these real-world use hold for the sense of Mees' lines this model covers, and on what evidence? provenance
Failure modes and hazards
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these failure modes and hazards hold for the sense of Mees' lines this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these neighbouring kinds and how to tell them apart hold for the sense of Mees' lines this model covers, and on what evidence? provenance
Classifiers Filled
- Family
- Thing Registry
- Category
- Cross-cutting context
- Entry kind
- thing
- Plane
- XCT
- Domain
- XCT.STA
What it is Filled
Mees' lines are transverse white bands in the nail plate, a form of true leukonychia caused by disturbed nail-matrix keratinisation, that do not blanch under pressure and move distally as the nail grows.
In scope
- Identification of transverse true leukonychia consistent with Mees' lines
- Band morphology and distribution across fingernails and toenails
- Pressure response, surface contour and movement with nail growth
- Temporal relationships to documented exposures, treatments and illnesses
- Diagnostic uncertainty, clinical review and serial observation
Out of scope
- Comprehensive anatomy and physiology of the nail apparatus
- Diagnosis and treatment of arsenic or other toxic exposures
- Management of systemic illnesses associated with nail changes
- Muehrcke's lines, Beau's lines and other nail disorders as independent conditions
- General chemotherapy prescribing and adverse-effect management
Why it exists Filled
Enable an agent to recognise, document and follow suspected Mees' lines while keeping the observed nail sign separate from any inferred underlying cause.
Distinguishing features Filled
- White transverse bands embedded in the plate support Mees' lines; punctate spots, longitudinal streaks and diffuse whitening require other classifications. [DermNet: White nail](https://dermnetnz.org/topics/white-nail)
- Persistence of whiteness under pressure supports true leukonychia over the apparent leukonychia of Muehrcke's lines. [Leukonychia review](https://pmc.ncbi.nlm.nih.gov/articles/PMC8809498/)
- Distal migration with nail growth supports a plate-based band; apparent leukonychia remains positioned over the nail bed. [Leukonychia review](https://pmc.ncbi.nlm.nih.gov/articles/PMC8809498/)
- Inspect and palpate for a transverse depression to distinguish a white band from a possible Beau's line, recording both features if they coexist.
- Superficial powdery or removable whiteness suggests pseudoleukonychia rather than an intrinsic white band. [Leukonychia review](https://pmc.ncbi.nlm.nih.gov/articles/PMC8809498/)
What robots and AI may and may not do Filled
Must not
- Diagnose poisoning or illness from photos of nails.
- Accuse a named person of poisoning someone on the basis of nail changes.
- Disclose a person's medical or toxicology findings without consent.
- Confuse the bands with harmless white spots and tell a person not to worry.
Only with a human decision
- Reporting suspected poisoning to authorities.
- Ordering or interpreting toxicology tests.
May
- Explain what Mees' lines are and the conditions linked to them from reputable medical sources.
- Advise a person who notices new white bands across several nails to see a doctor.
Moral aspects Filled
- Nail signs can point to poisoning, a crime that needs careful investigation, not rumour.
- Wrong suspicion can destroy relationships and reputations.
Who is affected
- Patients
- People suspected without evidence
- Families
Owners Filled
Steward
Nobody owns the sign; patients and their clinicians answer for care.
Links to other meta-models Filled
parent
- Q2084035 - registry parent class
What else AI and robots need to interact with it Filled
Identity and identifiers required Filled
- Vercy registry: vr.tr.mees-lines
- Wikidata: Q1567863 (https://www.wikidata.org/wiki/Q1567863)
Direct properties not applicable Not applicable
- Affected nails: Hand or foot, side and digit; inspected and uninspected nails distinguished
- Band geometry: Count per nail; width in mm; transverse coverage as percentage of plate width
- Band position: Distance in mm from proximal nail fold to a specified band edge, with observation date
- Pressure response: Persists; fades; indeterminate; not tested
- Surface contour: Smooth; depressed; ridged; scaling; mixed; not assessed
- Serial movement: Band displacement in mm over recorded days; indeterminate when observations are insufficient
- Candidate trigger: Linked exposure, medication course, illness or local injury with dates and evidence
- Identification state: Suspected; clinically supported; indeterminate; reclassified
Plane XCT: no invented physical properties.
Recognition optional Filled
- Single white bands running across the full width of the nail.
- Do not fade when the nail is pressed and move toward the tip as the nail grows.
- Often appear on several nails at the same level.
Capabilities and actions required Filled
- Create a nail-by-nail observation record with calibrated photographs
- Compare pressure response, contour and growth behaviour against competing explanations
- Track individual bands through serial examinations
- Construct a qualified timeline relating band development to documented events
- Prepare a clinical review summary showing supporting evidence and unresolved alternatives
- Revise the identification or causal interpretation when new examination findings arrive
Hazards and failure modes required Filled
- May be a late sign of heavy metal poisoning, chemotherapy or severe illness.
- Easily overlooked or mistaken for minor nail damage.
Standards and interfaces required Filled
- The International Classification of Diseases, Tenth Revision, issued by the World Health Organization, includes leukonychia under L60.8 for other nail disorders, providing a classification applicable to Mees' lines.
Context of use required Filled
- Mees' lines are encountered during nail examination as transverse white bands within the nail plate.
- They are documented alongside nail growth, medical history and other findings because their appearance alone does not establish an underlying cause.
Sources Filled
- Wikidata item Q1567863: Mees' lines - identity and sense of the item
- Wikipedia: Mees' lines - general description of the item
Open questions
- Should this registry entry adopt broad usage encompassing transverse true leukonychia or reserve the eponym for a narrower etiological context?
- What reproducible examination protocol and evidence threshold should distinguish suspected from clinically supported Mees' lines?
- How accurately can formation timing be estimated across different nails, growth disturbances and delays before a band becomes visible?
- Which reported etiological associations have evidence beyond isolated case reports, and how much diagnostic weight should each receive?
- Does an existing Vercy world model already own this clinical sign, requiring this registry entry to link to it instead of creating a duplicate?
Machine files
Provenance
thing registry research (pass 2) · unreviewed
Built from: models/things/publications/thing-q1567863/spec.json