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Apparent Leuconychia:
| • | Muehrke’s paired white bands |
True Leukonychia:
Apparent Leukonychia:
| • | white appearance of nail due to changes in underlying nail bed |
| • | it seems to me that these are all variations on a theme, and essentially the same finding; they overlap clinically and etiologically (decreased albumin can be seen in all of these conditions) |
Terry’s nails
| • | proximal white, distal normal |
Half and Half nails
| • | proximal white, distal red/brown (discoloration of the nail bed) |
Muehrke’s paired white bands
| • | parallel to lunula in the nail bed, with pink between 2 white lines |
| • | commonly associated with hypoalbuminemia |
True leukonychia:
| • | nail plate involvement (originates in matrix) |
Mee’s lines
| • | a typical syndrome of arsenic poisoning |
| • | appear as transverse white bands that move distally with nail growth (i.e. true leukonychia) |
| • | occurring at the same site in each nail |
Proximal portion of the matrix forms the superior aspect of the nail plate, and the distal matrix contributes to the inferior portion of the plate…
Pits:
| • | evidence of pinpoint damage to the matrix |
| • | represent loci where tiny clusters of parakeratotic cells have been shed from the surface of the nail plate |
White spots (leukonychia):
| • | result from damage to the distal matrix (vs. pits) |
| • | represent parakeratotic cells in the deeper portion of the nail plate |
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