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Leukonychia (Nail Disorder)

Several diseases of the nails can be developed as symptoms of hereditary or congenital syndromes while others may be associated with systemic and skin disorders. Leukonychia is one of those acquired disorders, often associated with hypoalbuminaemia that causes partial or complete white discoloration of the nails.

This condition may be present under other clinical circumstances or induced by the use of cytotoxic drugs as in transverse Leukonychia striae, also known as Muehrcke's lines. Leukonychias may appear as a rare side effect of systemic chemotherapy in some oncological patients but also be present with arsenic poisoning, renal failure, pneumonia or heart disease.

This nail disorder has different causes and stages; Leukonychia Partialis which is a phase of Leukonychia Totalis, Leukonychia autosomal dominant (congenital), transverse linear nail lesions, Muehrcke's Lines, Mees' Lines, among the main.

Different pigmentation is seen in some leukonychias; minor nail matrix, cuticle trauma or half and half nails with white color proximal and pink or red distal. Transverse Leukonychia shows white lines, Leukonychia Punctata is characterized by white spots and Terry's nails presenting all white nails associated with severe cardiovascular disease.

Nails may exhibit different abnormalities and compiled evidence has demonstrated that Leukonychia Striata and Leukonychia Totalis are distinct entities transmitted by automonal dominant gene. Much less secure is the status of Leukonychia partialis in which the nail is white proximally and pink near its free edge.

Historically, the term Leukonychia Totalis has priority over Leukonychia Partialis and the former descriptor should be used with the second considered as a variation of it.

The most common signs and symptoms of Leukonychia include camptodactyly, hammer toes, gingivitis, hyperkeratosis, abnormal colored nails, deafness, sensorineural, skin cysts, skin syndactyly of fingers, joint contractures and arthrogryposis. Transverse Leukonychia presents multiple white lines in the fingernails which cause is unclear, but probably as consequence of abnormal keratinocyte maturation.

Some considerations to take in mind regarding Leukonychia is that its presence 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.

Cosmetically, it is advisable to soften the cuticles first with warm water before pushing them back and use colored nail polish; acrylic nails or gel nails to cover those marks but being careful because any of these products may cause an allergic reaction in the surrounding skin which may damage the nails. If the condition persists or its cause is inexplicable, consider to be evaluated by a dermatologist or health care professional.