A case of Leukonychia with scanning electron microscope observation

Leukonychia is a medical term for white discoloration appearing on nails. The pathophysiologic mechanisms that cause white discoloration are not entirely clear. We processed a case of leukonychia with scanning electron microscope observation and found many crispy, obviously dissociated "layers" in the lower part of the white nail plate. The dissociated "layers" were composed of thick, loose, coarse keratin bundles intertwined with each other. We believe the dissociated "layers" are related to the clinically noted white discoloration appearing on the nails.