Hydroxyurea-induced azure lunula

Alteration in the color of the lunula can either be due to a cutaneous or systemic disorder or may be due to a drug effect. Azure or blue lunula is a disorder of pigmentation of nail lunula. This bluish discoloration was noted in fingernails of both hands and great toes. Hereby, we report a case of azure lunula in a child with sickle cell disease receiving oral hydroxyurea 500 mg daily.