Abstract: A variety of nail abnormalities have been described in Kawasaki disease (KD), including Beau's lines,1Bures F.A. Beau's lines in mucocutaneous lymph node syndrome.Am J Dis Child. 1981; 135: 383PubMed Google Scholar pincer nail deformity,2Vanderhooft S.L. Vanderhooft J.E. Pincer nail deformity after Kawasaki's disease.J Am Acad Dermatol. 1999; 41: 341-342Abstract Full Text Full Text PDF PubMed Google Scholar nail shedding,3Ciastko A.R. Onychomadesis and Kawasaki disease.CMAJ. 2002; 166: 1069PubMed Google Scholar, 4Pilapil V.R. Quizon D.F. Nail shedding in Kawasaki syndrome.Am J Dis Child. 1990; 144: 142-143PubMed Google Scholar and leukonychia partialis.5Iosub S. Gromisch D.S. Leukonychia partialis in Kawasaki disease.J Infect Dis. 1984; 150: 617-618Crossref PubMed Scopus (17) Google Scholar, 6Lindsay C. Nail-bed lines in Kawasaki disease.Am J Dis Child. 1992; 146: 659-660Google Scholar In a 6-month period, we observed leukonychia striata (LS) in 3 patients with KD. The first patient was a 21-month-old Asian boy treated with intravenous infusion of immunoglobulin (IVIG; 2g/kg) after 9 days of fever and 4 of 5 criteria for KD (no lymphadenopathy); the second patient was a 16-month-old native Canadian girl treated with IVIG (2g/kg) after 10 days of fever and 4 of 5 criteria for KD (no lymphadenopathy); and the third patient was a 6-year-old Hispanic boy treated with IVIG (2g/kg) after 5 days of fever and 3 of 5 criteria for KD (no lymphadenopathy or conjunctivitis). The patients also received low-dose aspirin. All patients had periungual desquamation and normal echocardiogram results in the subacute phase of the illness. At the 6-week follow-up visit, all patients had newly acquired LS noted on the fingernails (Figure), and the third patient also had Beau's lines on the toenails.See related article, p 888 See related article, p 888 LS (also called transverse leukonychia) are smooth bands, generally 2, that run parallel to the lunula across the width of the nail. The lines are non-palpable and, unlike Beau's lines, do not indent the nail. The etiology of LS is unknown. It may be caused by edematous tissue changes in the nail bed with or without hypoalbuminemia.7Grossman M. Scher R.K. Leukonychia: review and classification.Int J Dermatol. 1990; 29: 535-541Crossref PubMed Scopus (99) Google Scholar It has been suggested, in the context of KD, that leukonychia partialis, and likely LS, may be caused by localized vasculitis or nail bed hyperemia.5Iosub S. Gromisch D.S. Leukonychia partialis in Kawasaki disease.J Infect Dis. 1984; 150: 617-618Crossref PubMed Scopus (17) Google Scholar Both acquired and hereditary forms of LS exist. Previously reported associations of acquired LS include breast cancer, renal failure, systemic lupus erythematosus, zinc deficiency and chemotherapy.8Silverman R. Baran R. The nail.in: Schanchner L.A. Hansen R.C. Pediatric dermatology. 3rd ed. Mosby, Edinburgh2003: 77Google Scholar Acquired LS may be considered a nail abnormality associated with KD. Fever, Rash, and Dilated Coronary Arteries—An Unusual Presentation of a Rare Congenital Heart DefectThe Journal of PediatricsVol. 152Issue 6PreviewCoronary artery dilation in pediatric patients is most frequently seen in patients with Kawasaki disease.1 We describe an 8-year-old boy who presented with clinical signs of Kawasaki disease, fever, cracked red lips, polymorphous exanthema, and erythema of palms and soles. Two-dimensional echocardiography detected severe dilation of both coronary arteries. Because of the suspected diagnosis of Kawasaki disease, intravenous gamma globulin treatment was administered. The boy clinically recovered, but, during follow-up, coronary artery dilation persisted. Full-Text PDF