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Classification and external resources
ICD-10 L60.8, Q84.4
ICD-9 703.8, 757.5
DiseasesDB 14140

Leukonychia (or leuconychia), also known as white nails or milk spots,[1] is a medical term for white discoloration appearing on nails.[2]:658–9 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.

It is harmless and most commonly caused by minor injuries that occur while the nail is growing. Contrary to popular belief, the presence of leukonychia is not a sign of excess or deficiency of calcium or vitamins in the diet[3] but rather less commonly a medical sign of hypoalbuminemia of chronic liver disease. It is more commonly found on fingernails than toenails. There is no effective treatment for leukonychia. The white marks and spots gradually disappear as the nail grows outward from the matrix with the nail plate.[4]


Leukonychia partialis

Leukonychia totalis[edit]

This condition is a whitening of the entire nail. This may be a clinical sign of hypoalbuminaemia (low albumin), which can be seen in nephrotic syndrome (a form of kidney failure), liver failure, protein malabsorption and protein-losing enteropathies. A genetic condition, and a side effect of sulphonamides, a family of antibiotics can also cause this appearance.[5][6]

Leukonychia partialis[edit]

This condition is whitening of parts of the nail. Generally characterised by white dots. There are several types of this condition.

Leukonychia striata[edit]

Leukonychia striata

Leukonychia striata, transverse leukonychia, or Mee's lines are a whitening or discoloration of the nail in bands or "stria" that run parallel the lunula (nail base). It may be caused by cirrhosis, chemotherapy,[7] or physical injury to the nail matrix (e.g., excessive nail "tapping", or slamming in a car door).[8][9][10] Alternatively, the condition can be caused by arsenic, lead, or other heavy metal poisoning.[citation needed] 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.[11]

There is a similar condition called Muehrcke's lines (apparent leukonychia) which differs from leukonychia in that the lines fade with digital compression and do not migrate with the growth of the nail.[12]

Leukonychia punctata[edit]

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.[13]

Diagnosis and treatment[edit]

A doctor will take a thorough medical history, and may test liver and kidney function.


  1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 789. ISBN 0-7216-2921-0.
  2. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  3. ^ http://www.drweil.com/drw/u/QAA350576/white-spots-on-fingernails.html
  4. ^ http://www.ultimate-cosmetics.com/nail-disorders/leukonychia.htm
  5. ^ DermIS - Leukonychia Totalis (image)
  6. ^ Leukonychia Totalis information
  7. ^ Miles DW, Rubens RD (1995). "Images in clinical medicine. Transverse leukonychia". N. Engl. J. Med. 333 (2): 100. doi:10.1056/NEJM199507133330205. PMID 7777013. 
  8. ^ Medscape Today: Traumatic Transverse Leukonychia
  9. ^ DermIS - Leukonychia Striata (image)
  10. ^ Leukonychia Striata information
  11. ^ [1]
  12. ^ Huang, T.-C.; Chao, T.-Y. (14 December 2009). "Mees lines and Beau lines after chemotherapy". Canadian Medical Association Journal 182 (3): E149–E149. doi:10.1503/cmaj.090501. 
  13. ^ The Nail Geek: My Big Fat Greek Leukonychia

External links[edit]