Question:
The findings in image is suggestive of which poisoning
The findings in image is suggestive of which poisoning
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Transverse white nail bands (Mees' lines) plus thick, pigmented, scaly palms point to one chronic heavy-metal poison.
Updated On: Aug 27, 2026
- OPC
- Arsenic
- Lead
- Mercury
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Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Step 1: Read both images. The first photograph shows a fingernail crossed by transverse white bands (Mees' lines / leukonychia striata). The second shows the palms with marked hyperkeratosis and scaly/desquamating, pigmented skin. These are the classic dermatological signs of chronic heavy-metal toxicity.
Step 2: Match the signs to the metal. Chronic arsenic poisoning characteristically produces:
• Mees' lines - transverse white bands across the nails appearing weeks after exposure (the most specific nail sign of arsenic);
• Palmoplantar hyperkeratosis - wart-like thickening of palms and soles;
• 'Raindrop' (raindrop) pigmentation - hyperpigmentation with spots of normal skin.
The nail banding plus thick scaly hyperpigmented palms in the image fit arsenic.
Step 3: Eliminate the distractors.
• OPC (organophosphate, A): Acute cholinergic crisis - miosis, salivation, lacrimation, bronchorrhoea, fasciculations; it does NOT cause Mees' lines or palmar hyperkeratosis.
• Lead (C): Burton's blue line on the gum margin, basophilic stippling of RBCs, wrist/foot drop, lead colic, lead encephalopathy - not transverse nail bands with palmar keratosis.
• Mercury (D): Acrodynia (pink disease), tremor, erethism, gingivostomatitis and salivation; nail Mees' lines and palmoplantar hyperkeratosis are not its hallmark.
Step 4: Conclude. Transverse white nail bands (Mees' lines) together with hyperkeratotic, pigmented palms are pathognomonic of chronic arsenic toxicity.
Final answer: B - Arsenic.
Step 2: Match the signs to the metal. Chronic arsenic poisoning characteristically produces:
• Mees' lines - transverse white bands across the nails appearing weeks after exposure (the most specific nail sign of arsenic);
• Palmoplantar hyperkeratosis - wart-like thickening of palms and soles;
• 'Raindrop' (raindrop) pigmentation - hyperpigmentation with spots of normal skin.
The nail banding plus thick scaly hyperpigmented palms in the image fit arsenic.
Step 3: Eliminate the distractors.
• OPC (organophosphate, A): Acute cholinergic crisis - miosis, salivation, lacrimation, bronchorrhoea, fasciculations; it does NOT cause Mees' lines or palmar hyperkeratosis.
• Lead (C): Burton's blue line on the gum margin, basophilic stippling of RBCs, wrist/foot drop, lead colic, lead encephalopathy - not transverse nail bands with palmar keratosis.
• Mercury (D): Acrodynia (pink disease), tremor, erethism, gingivostomatitis and salivation; nail Mees' lines and palmoplantar hyperkeratosis are not its hallmark.
Step 4: Conclude. Transverse white nail bands (Mees' lines) together with hyperkeratotic, pigmented palms are pathognomonic of chronic arsenic toxicity.
Final answer: B - Arsenic.
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