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"textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 40-year-old man was referred for impairment of the second finger of the right hand with suspected onychomycosis. The case history included a family history of insulin-dependent diabetes mellitus and 2 relatives who died due to liver disease of unknown origin. During the examination, we observed a brown-purplish area with distinct edges, corresponding to the reason for the consultation and compatible with subungual hematoma. There was a notable white-pink coloration arranged half-and-half on all nails of the hands (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Laboratory tests showed an increase in transaminases, with a predominance of the cytolytic pattern (glutamic oxaloacetic transaminase 205 IU/L and gamma-glutamyl transferase 300 IU/L) compared with the cholestatic pattern (total bilirubin 0.5 mg/dL, gamma-glutamyl transferase 65 IU/L and alkaline phosphatase 178 IU/L). Protein electrophoresis showed hypergammaglobulinemia due to IgG. The autoimmunity study showed high titers of antinuclear (1/320), anti-smooth muscle (1/320), liver and/or kidney microsomal (1/160) and soluble liver antigen/liver pancreas (1/320) antibodies. The results of a complete hepatic viral serology were negative, ruling out hepatitis of infectious origin. The patient was referred to the Department of Gastroenterology for treatment and follow-up of autoimmune hepatitis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Half-and-half nails or Terry’s nails are an uncommon finding; however, recognizing the meaning of this sign is crucial for a correct approach and for the association with severe internal organ impairment. The condition has been related to cirrhosis, chronic renal failure and congestive heart failure and has also been associated with patients with type 2 diabetes mellitus, acute viral hepatitis, vitiligo and tuberculoid leprosy.</p></span>"
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