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Year : 2000  |  Volume : 66  |  Issue : 6  |  Page : 312-313

Leuconychia Totalis

Correspondence Address:
Rani Radha Mittal

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Source of Support: None, Conflict of Interest: None

PMID: 20877113

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A case of leukonychia totalis in a 20-year old. healthy man which manifested at the age of 2 years after an episode of acute illness is being reported.

Keywords: Leukonychia totalis, Nail

How to cite this article:
Mittal RR, jassal J S, Jain C, Kullar. Leuconychia Totalis. Indian J Dermatol Venereol Leprol 2000;66:312-3

How to cite this URL:
Mittal RR, jassal J S, Jain C, Kullar. Leuconychia Totalis. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2020 Aug 13];66:312-3. Available from:

  Introduction Top

Leukonychia or white nails may be total, partial, striate or punctate.[1] Leukonychia totalis is a rare nail disorder which may be hereditary or acquired. Hereditary or congenital leukonychia,[2] is present since birth, with positive family history and has autosomal dominant inheritance. Acquired leukonychia totalis appears in early childhood.[2] The white nail has been associated with various diseases or with occupation. Frequently the cause may be obscure. Albright quoted Giovannini that leukonychia totalis develops after typhoid fever. Baran and Dawber also reported leukonychia after infectious diseases such as measles and herpes zoster.[4] The other causes may be leprosy, exposure to extreme cold, hepatic cirrhosis, ulcerative colitis, onychophagia, anemia, hypoproteinemia or occupational trauma.

  Case report Top

A 20- year- old boy well built, and well nourished developed persistent whitening of all the finger and toe nails suddenly, at the age of 2 years, after acute illness associated with fever for 15 days.

Various nodes of therapy were tried without any beneficial effect. He was the product of non consanguinous marriage, with normal gestation and delivered by normal vaginal delivery. The physical and mental mile stones were normal before and after the illness. There was no family history of leukonychia or of any other dermatological condition. The nails were strikingly white, with smooth surface and normal strength of the nail plate. The nail bed, nail folds and the edges of the nails were normal. The teeth, eyes, hair, skin of the body and palms and soles, showed no abnormality. The routine hemogram, urinalysis, liver function tests, renal function tests, total and differential proteins were all within normal limits. The nails were negative for fungus on direct examination and on culture repeatedly. [Figure - 1]

  Discussion Top

Leukonychia totalis is a rare nail disorder and still rarer is the fact that all twenty nails were affected in childhood in our patient. The congenital/ hereditary type of leukonychia manifests at birth or during early infancy, but acquired type appears in childhood.[2]

The present case of leukonychia totalis developed total whiteness of all twenty nails, suddenly, after prolonged fever. So in this case the cause could be pathogens or drugs which were given to treat the infection. As no improvement occurred after various medicaments and the condition still persists after 20 years, it is obvious that leukonychia totalis represents a chronic, treatment resistant, permanent deformity of nails.

  References Top

1.Dawber RP, Baran R. Disorders of Nail. In Textbook of Dermatology. Eds. Champion RH, Burton 31, Ebling FJG. Blackwell Scientific Publication. London 1992;2511.  Back to cited text no. 1    
2.Albright SD, Wheeler CE, Chapel H. Leukonychia. Arch of Dermatology 1964;90:392-398.  Back to cited text no. 2    
3.Giovannini S. International Atlas of Rare Skin diseases. Hamburg and Leipzig L Voss, 1891, Plate 19.  Back to cited text no. 3    
4.Baran R, Dawber RPR. Physical signs. In: Disease of Nails and their management. Eds. Baran R Dawber RPR. Blackwell Scientific Publication London 1984; 73-75.  Back to cited text no. 4    


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