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Leukonychia and Other Nail Discoloration: Overview

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    AMA Citation
    Leukonychia and Other Nail Discoloration: Overview. In: Bissonnette B, Luginbuehl I, Marciniak B, Dalens BJ. Bissonnette B, Luginbuehl I, Marciniak B, Dalens B.J. Eds. Bruno Bissonnette, et al.eds. Syndromes: Rapid Recognition and Perioperative Implications New York, NY: McGraw-Hill; 2006. http://accessanesthesiology.mhmedical.com/content.aspx?bookid=852&sectionid=49517858. Accessed March 29, 2020.
    MLA Citation
    . "Leukonychia and Other Nail Discoloration: Overview." Syndromes: Rapid Recognition and Perioperative Implications Bissonnette B, Luginbuehl I, Marciniak B, Dalens BJ. Bissonnette B, Luginbuehl I, Marciniak B, Dalens B.J. Eds. Bruno Bissonnette, et al. New York, NY: McGraw-Hill, 2006, http://accessanesthesiology.mhmedical.com/content.aspx?bookid=852&sectionid=49517858.

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See Table L-2.

Table L-2 Leukonychia and Other Nail Discoloration
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Table L-2 Leukonychia and Other Nail Discoloration
Nail Discoloration (Name)Clinical Aspect and Causes
Leukonychia Totalis (partial or totalis white nails) Congenital (leukonychia totalis): autosomal dominant syndrome
Terry nails (either all or only proximal 80% of nail bed is white): liver disease (cirrhosis)
Half-and-half nails (pink proximally, white distally): renal failure, uremia
Leukonychia punctata (white spots) Minor trauma to nail cuticle or matrix
Transverse striate leukonychia (white lines) Muehrcke lines (transverse white lines): hypoalbuminemia
Mees lines (transverse white lines): heavy metal poisoning (arsenic), renal failure
Green nailsPseudomonas pyocyanea infection (candidiasis)
Blue and brown nailsMedication side effect (quinacrine, chloroquine, minocycline [blue nails], doxorubicin, melphalan, bleomycin, daunorubicin)
Wilson disease
Ochronosis
Psoriasis
Alopecia areata
Consider staining (nicotine, potassium permanganate, varnish)
Black nails (melanonychia) Medication side effects (cyclophosphamide)
Melanonychia striata: common in dark-skinned persons; idiopathic or secondary to trauma or chemotherapy
Nevus (uniform brown longitudinal streak localized to nail)
Melanoma (longitudinal brown-black streak that may encompass entire nail)
Hematoma
Yellow Nail SyndromeLymphedema
AIDS
Bacterial infection
Fungal infection (onychomycosis)
Psoriasis
Alopecia aerata
Cardiopulmonary diseases
Red nails (including red and white streaks) Darier disease
Glomus tumor

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