A 45-year-old man had white nails for as long as he could remember. His health was good and, specifically, he had no history of cirrhosis, heart disease, renal failure, or pulmonary disease. True leukonychia results from opacification of the nail plate by abnormal keratinization or the presence of air from resorption of acellular debris. The nail may also apprear white in patients with onycholysis or changes in the nail bed. Although nail bed changes may be associated with chronic systemic disease, it can also occur as a normal variant and may be familial. Note the narrow distal band of normal appearing nail in this man.
A 45 y/o man with white nails. Althought white nails have been described in association with cirrhosis and congestive heart failure, this man is otherwise healthy. No hepatic, renal, cardiac and endocrine abnormality was detected.