Idiopathic Acquired True Leuconychia Totalis and Partialis: A Rare Case Report

Abstract

The patient presented to Dermatology Out Patient Department with whitish discolouration of all fingernails for 5 years and few toe nails for 2 years. He initially noticed partial synchronous whitish discolouration of all fingernails which gradually involved the entire nail plates resulting in total leuconychia. After 3 years, he also observed partial whitish discolouration of few of the toe nails. There was no history of trauma, drug intake and exposure to chemical agents or significant illness. The patient had no central nervous system, eye, ear, hair, teeth, or skin abnormalities. There was no family history of skin or nail disease and the patient were born to non consanguineous marriage. The general and systemic examination revealed no abnormality. On local examination, total leuconychia of all the finger nails and partial to total leuconychia of all the toenails was seen (Figures 1 and 2). The periungual areas were healthy. Complete hemogram, liver and kidney function tests were within normal limits and ELISA for HIV test was nonreactive. Repeated potassium hydroxide preparations and fungal cultures of the white nails were negative. The patient was advised for follow up to see any further increase in toenail leuconychia.