Leukonychia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Synonyms and keywords: Leuconychia

Leukonychia is a medical term for white discoloration appearing on nails. It is derived from the Greek words Leuko white and Onyx nail. The most common cause is injury to the base of the nail (the matrix) where the nail is formed.

Leukonychia Totalis: This condition is a whitening of the entire nail. This may be due to hypoalbuminaemia, a genetic condition, or a side effect of sulphonamides, a family of antibiotics.^[1]

Leukonychia Partialis: This condition is whitening of parts of the nail. There are several types of this condition.

Leukonychia Striata or Transverse Leukonychia: This is a whitening or discoloration of the nail in bands or “stria”. It may be caused by cirrhosis, chemotherapy, or physical injury to the nail matrix. (i.e. excessive nail “tapping” or slamming in a car door).^[2]

This condition looks similar to Mee’s lines, a condition caused by Arsenic, Lead, or other heavy metal poisoning.

True Leukonychia: This is the most common form of Leukonychia, small white spots on the nails. Picking and biting of the nails are a prominent cause in young children and nail biters. In most cases, when white spots appear on a single or a couple of fingers or toes, the most common cause is injury to the base (matrix) of the nail. When this is the case, white spots disappear after around eight months, which is the amount of time necessary for nails to regrow completely.^[3]

White spots showing up on all or nearly all nails for longer periods of time (months and years) can be due to one of several reasons. One common explanation is zinc deficiency.^[4]

• Kidney disease
• Liver disease

• Anemia
• Arsenic poisoning
• Calcium deficiency
• Cardiac Diseases
• Cirrhosis
• Congenital isolated nail dysplasia
• Darier’s disease
• Fever
• Hypoalbuminemia
• Iron deficiency
• Leprosy
• Malabsorption
• Mycosis
• Nitrate solution
• Silver solution
• Sulphonamides
• Noxa
• Steatocystoma multiplex
• Trauma
• Vitiligo
• Witkop syndrome
• Zinc deficiency

A doctor will take a thorough medical history, and may test liver and kidney function.

• 
  Leukonychia. Adapted from Dermatology Atlas.^[5]
• 
  Leukonychia. Adapted from Dermatology Atlas.^[5]

If a zinc deficiency is identified, a diet rich in zinc or zinc supplements may be administered.

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