Pigmentations of the Nails

Punctate leukonychia is particularly frequently seen in young girls when they start to perform their own manicure. It is thought to be of traumatic origin, but this only explains a part of the cases. Punctate und short striate leukonychia is often a sign of a hammer blow when it overlies a subungual hematoma. Crush injuries are usually bigger (Figure1). Transverse leukonychia may be a sign of limited growth retardation, such as after high fever or during chemotherapy cycles. Longitudinal leukonychia is usually the sign of a thread of subungual keratin, such as in subungual filamentous tumor or onychopapilloma. Diffuse leukonychia may be congenital or acquired; the latter is often seen in chronic hepatic disease. When the distal third or half of the nail is normal it is called partial leukonychia. So-called half-and-half nails are a sing of chronic renal failure (Figure 2).