Leukonychia
Encyclopedia
Leukonychia also known as white nails, is a medical term for white discoloration appearing on nails
Nail (anatomy)
A nail is a horn-like envelope covering the dorsal aspect of the terminal phalanges of fingers and toes in humans, most non-human primates, and a few other mammals. Nails are similar to claws, which are found on numerous other animals....

. 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.

The presence of leukonychia is not a sign of a lack of vitamin or calcium in the diet, is harmless and may be caused simply from a minor injury that occurs when the nail is growing and that it is much more common on fingernails than toenails. There is no effective treatment for Leukonychia although reducing minor injury to the nails prevents the white marks and spots that will gradually disappear as the nail grows outward from the matrix with the nail plate and eventually disappear.

Leukonychia totalis

This condition is a whitening of the entire nail. This may be due to hypoalbuminaemia (low albumin), which is caused by the nephrotic syndrome (a form of kidney failure), liver failure, protein malabsorption and protein-losing enteropathies
Enteropathy
-Types:Specific types of enteropathy include:* Gluten-sensitive enteropathy * Hemorrhagic enteropathy* Protein-losing enteropathy* Porcine proliferative enteropathy * Radiation enteropathy...

. A genetic
Genetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....

 condition, and a side effect of sulphonamides
Sulfonamide (medicine)
Sulfonamide or sulphonamide is the basis of several groups of drugs. The original antibacterial sulfonamides are synthetic antimicrobial agents that contain the sulfonamide group. Some sulfonamides are also devoid of antibacterial activity, e.g., the anticonvulsant sultiame...

, a family of antibiotics can also cause this appearance.

Leukonychia partialis

This condition is whitening of parts of the nail. Generally characterised by white dots. 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" that run parallel the lunula
Lunula (anatomy)
The lunula, or lunulae , is the crescent-shaped whitish area of the bed of a fingernail or toenail. The lunula is the visible part of the nail matrix The lunula, or lunulae (pl.) (little moon in Latin), is the crescent-shaped whitish area of the bed of a fingernail or toenail. The lunula is the...

 (nail base). It may be caused by cirrhosis
Cirrhosis
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules , leading to loss of liver function...

, chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

, or physical injury to the nail matrix (e.g., excessive nail "tapping", or slamming in a car door). Alternatively, the condition can be caused by arsenic
Arsenic
Arsenic is a chemical element with the symbol As, atomic number 33 and relative atomic mass 74.92. Arsenic occurs in many minerals, usually in conjunction with sulfur and metals, and also as a pure elemental crystal. It was first documented by Albertus Magnus in 1250.Arsenic is a metalloid...

, lead
Lead
Lead is a main-group element in the carbon group with the symbol Pb and atomic number 82. Lead is a soft, malleable poor metal. It is also counted as one of the heavy metals. Metallic lead has a bluish-white color after being freshly cut, but it soon tarnishes to a dull grayish color when exposed...

, or other heavy metal
Heavy metals
A heavy metal is a member of a loosely-defined subset of elements that exhibit metallic properties. It mainly includes the transition metals, some metalloids, lanthanides, and actinides. Many different definitions have been proposed—some based on density, some on atomic number or atomic weight,...

 poisoning.
The tendency toward leukonychia striata is sometimes inherited in an autosomal dominant fashion. In other cases, it can be attributed to vigorous manicuring, to trauma, or to a wide variety of systemic illnesses. In many patients, there is no obvious cause, and the streaks resolve spontaneously.

There is a similar condition called Muehrcke's lines
Muehrcke's lines
Muehrcke's nails, Muehrcke's lines, or leukonychia striata, are changes in the fingernail that may be a sign of an underlying medical disorder or condition. Muehrcke's lines are white lines that extend all the way across the nail and lie parallel to the lunula . In contrast to Beau's lines, they...

 which differs from leukonychia in that the lines run across the entire nail bed and occur in more than one nail.

Leukonychia punctata

Also known as "true" leukonychia, this is the most common form of leukonychia, in which small white spots appear 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 weeks, which is the amount of time necessary for nails to regrow completely.

Diagnosis and treatment

A doctor will take a thorough medical history
Medical history
The medical history or anamnesis of a patient is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information , with the aim of obtaining information useful in formulating a diagnosis and providing...

, and may test liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

 and kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...

 function.

External links

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