Figure 1: partial to total leukonychia of all finger and
toenails
The routine laboratory investigations like complete blood count, liver
and renal function tests were done and found to be within normal limits.
Hemoglobin was 14.9 gm /dl, total leucocyte count 4800/ mm3, platelets
264000/mm3, total bilirubin -0.5mg/dl, conjugated bilirubin- 0.2 mg/dl,
SGPT-15U/L, SGOT-11 U/L, ALP- 81 U/L, urea- 12 mg/dl, creatinine - 0.4
mg/dl, Na- 142, K- 4.0). Further workup including serum albumin, serum
calcium, urine analysis, thyroid function test, parathyroid function,
chest X-rays, echocardiography, ultrasonography of abdomen and pelvis,
iron studies, vitamin assays, antinuclear antibodies did not detect any
abnormality. Potassium hydroxide mount and fungal cultures of the nails
were negative. So, the diagnosis of Idiopathic Acquired True Leukonychia
Totalis and Partialis was made and the patient was counseled regarding
the disease. On 1 year follow up, no other changes were noted in the
nails. The leuconychia was persistent.