# Dermatology (Beau’s Lines) and Forensic Pathology (Harris Lines and Linear Enamel Hypoplasia) Signs of Growth Arrest: A Case Report and Literature Review

## TL;DR

This paper discusses how trauma and systemic issues can cause growth arrest in nails, bones, and teeth, using a case study and literature review.

## Contribution

The paper connects dermatological, forensic, and dental signs of growth arrest through a case report and literature review.

## Key findings

- Beau’s lines in nails can appear 10 weeks after trauma.
- Growth arrest signs like Harris lines and linear enamel hypoplasia are linked to systemic issues.
- Diagnostic signs of growth arrest can be identified through skin, radiologic, and oral exams.

## Abstract

Dermatology encompasses the evaluation and management of localized conditions that affect the nail plate, including trauma, primary dermatoses involving the nail bed and nail matrix, and systemic disorders with manifestations that impact the nail unit. In addition to traumatic events that can alter the nail unit, localized conditions such as periungual dermatitis and infections, as well as generalized diseases, can affect the nail matrix, resulting in temporary growth arrest of the nail plate. This can present as a groove (Beau’s line) in the nail plate that progressively grows out as the nail continues to grow. Forensic pathology includes forensic anthropology. Disease and starvation are the most common etiologies associated with growth arrest of the long bones near the epiphyseal plate; the radiolucent horizontal bands (Harris lines) are only observable on the roentgenogram. Localized injuries, malnutrition, and childhood illnesses can result in growth arrest of enamel formation in the teeth (linear enamel hypoplasia); this condition appears as white pits, grooves, and/or bands on the crowns of permanent teeth. A 65-year-old man experienced a trauma-associated Beau’s line on his left great toenail plate. He developed a subungual hematoma; approximately 10 weeks after the injury, he noted the appearance of a Beau’s line. Growth arrest of the nail plate (Beau’s lines), growth arrest of the long bones near the epiphyseal plate (Harris lines), and growth arrest of the teeth’s enamel formation (linear enamel hypoplasia) can be caused by adverse events such as systemic illnesses, malnutrition, medication effects, and trauma. In conclusion, diagnostic stigmata of growth arrest, such as Beau’s lines of the nail plate, Harris lines of the long bones, and linear enamel hypoplasia of the teeth, can be detected during the cutaneous inspection of the nails, the radiologic evaluation of the long bone, and the oral examination of the teeth.