Leukonychia

Characteristics

Leukonychia is one of the most common dermatological diseases causing pigmentary changes in this skin appendage. It consists of white spots on the nail plate, which can range from oblong to round, and can occur singly or in clusters. The discolorations may be few in number or cover the entire plate of one or more nails. Leukonychia can occur in anyone, regardless of age or gender. Leukonychia should not be underestimated – although it looks harmless, it may indicate many serious diseases in the body, for example kidney failure or cirrhosis.

Types of leukonychia:

Leukonychia can be divided by the time the change in nail coloration occurred. We distinguish:

• Acquired leukonychia
• Congenital leukonychia

Considering the clinical picture, it is possible to distinguish between:

• Total leukonychia – involves the entire nail plate
• Partial leukonychia is divided into:
  • Leukonychia partialis – lesions occur on one half of the nail
  • Leukonychia striata – manifested by longitudinal white streaks of varying width
  • Leukonychia transversalis – lesions resemble transverse white stripes
  • Leukonychia punctatum – manifests as multiple white macules 1-2 mm in diameter

However, the most relevant division of the disease is the one classifying leukonychia by the part of the nail occupied:

• Genuine leukonychia – lesions involve the nail bed
• Pseudoleukonychia – lesions develop in subungual tissues
• Apparent leukonychia – lesions develop in the nail plate

Causes of leukonychia

Genuine leukonychia does not disappear when pressure is applied to the nail and moves as the nail grows. It can be caused by deficiencies of mineral salts, nutritional values and elements, especially calcium and zinc. Unfortunately, this form of the disease is also found in the course of heart failure, psoriasis, kidney failure or alopecia areata. Genuine leukonychia can also be caused by heavy metal poisoning.

Pseudoleukonychia is often caused by nail trauma, improper manicures and pedicures, or the use of improper nail polish. This form of the disease also accompanies psoriasis and onychomycosis. As in the genuine variety, it does not disappear when pressure is applied to the nail and moves as the nail grows.

Apparent leukonychia may occur due to hyperhidrosis, kidney disease, anemia, or leprosy. Unlike the previous types of the disease, apparent leukonychia does not move with the growth of the nail and disappears under pressure.

Diagnosis of leukonychia

If you notice the first symptoms of leukonychia, see a dermatologist immediately. The most important factor in treating leukonychia is to determine its cause, thus during the interview, your physician will ask you about the diseases and drug therapy you are using. If your known medical history does not predispose you to this condition, your physician may recommend additional examinations, most commonly a blood count. Although the symptoms of leukonychia are characteristic, you should not diagnose the disease on your own. A visit to an experienced dermatologist is necessary to diagnose the condition and implement optimal treatment.

Treatment options for leukonychia

Treatment of leukonychia is based on treating its cause. If the disease is caused by a deficiency of vitamins, mineral salts and elements, your physician will recommend how to supplement these deficiencies. If the white lesions on nails appeared in parallel with a deterioration of your general health, the treatment of leukonychia must be combined with the diagnosis of a potential disease and its stabilization or cure. If the condition is associated with onychomycosis or psoriasis, treatment specific to these conditions is necessary. Leukonychia can be a cosmetic defect, so unless there are contraindications, your dermatologist will advise you on what polish you can safely cover the white lesions with.

If you notice white spots on your hands or toenails or you are concerned about the condition of your nails, we invite you to a professional dermatological consultation, during which we will diagnose the problem and present available treatment methods.

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