Leukonychia: What Can White Nails Tell Us?

Proximally white and distally pink nails

“…Half-and-half nails have also occasionally been reported in other conditions, including Kawasaki’s disease, Behcet’s disease, Crohn’s disease, Graves’ disease, pellagra, cirrhosis, HIV infection, and after isoniazid therapy, but also in healthy individuals 12. Differentiating from Terry’s nails can be challenging: Terry’s nails show a similar apparent leukonychia with a distal pink or brown band of 1-2 mm wide, and they are associated with liver disease, cirrhosis, chronic congestive heart failure, chronic kidney disease, and adult-onset diabetes as well 1…”

“…Leukonychia, or white nails, can be caused by abnormalities of the nail plate or nail bed and is classified anatomically into three subtypes: true leukonychia (Mees lines and hereditary leukonychia totalis), apparent leukonychia (Muehrcke’s lines, half-and-half nails, and Terry’s nails), and pseudoleukonychia (onychomycosis and exogenous compound) 1…”

“…Half-and-half nails appear as two-coloured nails with a transverse border: the proximal part of the nail bed is whitish; the distal part is red, pink, or brown and occupies 20-60% of the nail length 1. They are seen in approximately 10-50% of patients with chronic kidney disease 12. The pathophysiology is unclear.…”

44-jähriger Patient mit Veränderungen aller Nägel

“…Bei den Mees-Bändern handelt es sich um ein rein kosmetisches Problem. Eine Therapie besteht aktuell nicht 2 3 . In unserem Fall repräsentiert jedes Band einen Chemotherapiezyklus.…”

“…Diese grenzt sich halbmondartig scharf zu einer rot-bräunlichen Verfärbung des proximalen Nagels ab. Auslöser ist meist eine Azotämie infolge einer terminalen Niereninsuffizienz 3 .…”