How do you prevent a white nail?Īvoidance of trauma-induced leukonychia will help prevent development of white nails. Punctate lesions will disappear as the nail follows its natural growth pattern (around 6 to 9 months for a fingernail). There is no treatment for trauma-related leukonychia. Treatment ultimately depends on the presence of any underlying cause. They appear similar in different skin types.Ĭlick here for more images What is the treatment for a white nail? This is also true of leukonychia extending the full width of the nail plate.Ĭlick here for images How do clinical features vary in differing types of skin? Patients with multiple true leukonychia warrant a thorough history, physical examination, and medication review to exclude a toxic or systemic etiology. One or more white horizontal bands across the entire nail in parallel with the lunula.Striate or transverse leukonychia (Mees line):.Presenting in individuals with Darier disease or Hailey-Hailey disease.Tends to be the result of trauma and isolated to a few nails.Described as small white spots on the nails.True leukonychia with partial distribution: What are the clinical features of a white nail? Muehrcke lines have been associated with: Hypoalbuminemia (due to protein malabsorption, eg, in colitis).Terry nails: Whitening of the majority of the nail with a thin 0.5-3.0 mm distal darkening.Lindsay nails (half-and-half nails): Proximally white or pink-coloured nail with a distal darkening.Muehrcke lines: A pair of observable, non- palpable, horizontal (transverse) white lines across the nail due to variable blood flow.There are three distinct types of apparent leukonychia that may be associated with the systemic disease: Heavy metal poisoning (eg lead, arsenic).Mees line, Lindsay nails, Muehrcke lines (see below), and punctate leukonychia may be associated with: Total leukonychia: can follow a more serious injury, often with detachment of the nail plate from the nail bed, and alteration to the nail contour.Striate leukonychia: also known as Mees lines or transverse leukonychia, may follow damage to the nail matrix furrows and ridges may also appear.Punctate leukonychia: occurs after nail biting, manicuring, knocks and bangs, and tight footwear use.Keratin disruption with trapped air within the nail plate, resulting in reflection and lack of transparency. True leukonychia: partial or whole nail plate damage caused by injury to the nail plate or matrix.Its presence may warrant a work-up for systemic disease. White nails can affect anyone of any gender, age or ethnicity. Important to note that congenital leukonychia may also be secondary to systemic disease (see below). Acquired: secondary to systemic disease.This is due to a mutation in the phospholipase C delta-1 gene in which all nails appear milky and porcelain white. Congenital: familial leukonychia is more commonly inherited recessively, although dominant patterns are possible.White nails can be acquired or congenital. Partial leukonychia: 3 subtypes are described.Total leukonychia: whitening of the entire nail plate. This appearance disappears with pressure application on the nail.
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