Leukonychia in Adult
True leukonychia may appear as either an acquired or an inherited trait. The genetic form is rare and may occur alone or in association with other hereditary conditions such as keratodermas. Other conditions that can be seen with hereditary leukonychia include deafness, accelerated nail growth, and koilonychia.
When acquired, true leukonychia usually appears as one or more transverse white bands running parallel to the distal margin of the lunulae (also called Mees lines). These lines are often located at the same level on each nail and will move distally and disappear as the nail grows out. The pathogenesis is thought to be a disruption of nail plate keratinization secondary to systemic stress. This pattern was originally reported with arsenic poisoning but is seen with chemotherapy, systemic infections, severe hypocalcemia, and trauma, to name a few causes. Total leukonychia has been reported in HIV-infected patients.
Punctate leukonychia is a pattern of true leukonychia that is usually seen in children and is secondary to trauma. Small white marks grow out with the nail.
Apparent leukonychia (Terry nails, half-and-half nails, Muehrcke lines) is often seen with chronic renal failure, nephrotic syndrome, cirrhosis, congestive heart failure, and adult onset diabetes. Nail bed pallor may be due to anemia, edema, or vascular impairment.
For more information, see OMIM.
L60.8 – Other nail disorders
111202002 – Leukonychia
- Inherited true leukonychia
- Trauma (single or repeated)
- Metabolic and endocrine disturbances
- Peripheral neuropathy
- Renal disease
- Infectious diseases
- Poisons/drugs (arsenic, chemotherapy)