Transverse leukonychia (also known as leukonychia striata) is characterized by white horizontal bands on the nail plate. There are three anatomic subtypes, including transverse true leukonychia, transverse apparent leukonychia, and transverse pseudoleukonychia. Transverse leukonychia is sometimes used interchangeably with Mees’ lines, though some authors reserve the term Mees’ lines for transverse true leukonychia secondary to arsenic poisoning [1]. Muehrcke’s lines are a type of transverse apparent leukonychia associated with systemic disease. The pathogenesis in transverse true leukonychia is abnormal nail matrix keratinization, whereas transverse apparent leukonychia (Muehrcke’s lines) is caused by vascular abnormalities in the nail bed [2].