Case Report
17 years old male presented to our OPD with history of whitening of his finger and toenails. The nail changes started as ill-defined white discoloration on few finger and toenails which gradually and synchronously progressed to almost total whitening of all the twenty nails over 3 years. The growth of the nails was otherwise normal. He was born out of a non-consanguineous marriage. His developmental milestones were normal. He had no previous medical or surgical history. He denied history of any medications, exposure to chemicals or mechanical trauma to the nails. There was no history of leukonychia or other dermatologic diseases in family.
On physical examination, partial to total leukonychia of all finger and toenails was observed. Few nails had a totally white discoloration. Most of the nails had a pink transverse band about 2- 3 mm wide at the distal edge. The nail folds and cuticles were normal. The nail surface was smooth with no pitting, crumbling or nail thickening (Figure 1). On applying pressure on the nail plate, white color did not disappear. Thorough systemic examinations did not reveal any abnormalities.