Leukonychia: My Prize for Chasing White Birds.

As a kid growing up in Nigeria, I had a favorite daytime game. It involved singing while chasing after white birds flying in the sky, waving my fingers furiously at them.

The most important part of playing this game was what I hoped to get in return; white fingernails or better still, white markings or spots on my fingernails.

The standard song for this game was sung in my local language and revolved around asking the white birds to give me fingernails as white as themselves.

Till this day, my prizes won on these occasions remain on my fingernails long after I quit the game. The birds always listened or so I thought.

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What Begged the Question

I became too old to be seen running through the streets, singing and waving at birds that were way faster than me. Age had turned me against my favorite game making me realize how ridiculous it would seem to an onlooker. As such, it has been years since I last partook in this game. I however had my prizes as a constant reminder and soon, their continued presence peaked my curiosity.

Why did I still have the white spots on my fingernails many years after?

These white spots appeared on my toenails too; were they bonuses for previous jobs well done?

The white spots disappear sometimes only to appear again just when I thought I was finally rid of them.

Where do they go? Why do they return? Doesn't another child somewhere need or deserve them more than I do?

As the popular saying goes; "Google is your friend", so off I went to visit my brainy friend.

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The Disillusionment...

It turned out that my prize has a name; leukonychia and they are far from being prizes.

This disillusionment made me question my childhood beliefs; how come the white marks came each time I sang for them? Maybe they did or maybe they didn't; they had certainly not come from the white birds.

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Leukonychia

The word "Leukonychia" has its origin in the Greek words 'Leuko' which means white and 'Nychia' meaning nails. It refers to my prize; the white discoloration found on the nails and is also called white nails or milky spots.

Asides my superstitious belief as to how they come to be on the nails, some people also believe they are as a result of calcium inadequacy in the body.

Mothers have been known to tell their children to drink more milk to make the spots disappear. As you will come to know in this article, these notions are wrong. The "milk" in "milk spots" should not be literally interpreted.

According to the National Health Service (NHS), most of these white spots are nothing to worry about but some are symptoms for previous or impending illnesses or conditions. In their own words; “White spots or streaks are normal and nothing to worry about, but parallel white lines that extend all the way across the nails, known as Muehrcke’s lines, are a sign of low levels of protein in the blood.”

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There are two broad classifications and four types of leukonychia, obviously classified according to the degree to which the white spots cover the nails.

The broad classifications are:

1. True Leukonychia: the white spots are caused by injury or damage to the nail and do not fade when pressure is applied to the nails. In cases of true leukonychia, the milky spots grow out with the nails. In other words, true leukonychia results due to the continued presence of nuclei in the nail bed.

2. Apparent Leukonychia: also called Muehrcke's lines, it is thus classified when the nail bed beneath the nails is affected and its pallor in turn, causes the discoloration to the nail plate. If pressure is applied on the nail in these cases, the white spots will fade or lessen but will not grow out with nail growth.

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The specific types of leukonychia are: leukonychia totalis, leukonychia partialis, striata leukonychia and longitudinal leukonychia. Some of their possible causes are mentioned too.

• Leukonychia Totalis: the nail plate is completely covered by the white discoloration.

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Possible causes: this appearance can be a side effect of sulphonamides (a family of antibiotics), a symptom of low albumin; seen in a form of kidney failure, a genetic condition, liver failure, heart disease, diabetes, and faulty absorption of protein among others.

• Leukonychia Partialis: it refers to when parts of the nail plate is discolored in form of white spots. This type of leukonychia is also an umbrella for the other types of leukonychia in which the nails are partially covered like the striata/transverse, the longitudinal and the punctate leukonychia.

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Possible causes: its most common causes are biting of the nails and trauma while in very rare cases, they could be symptoms of sickle cell anemia, Hodgkin's disease, or malaria.

• Leukonychia Striata: also called transverse leukonychia or Mees' lines, it refers to discoloration that occurs in form of horizontal lines that run parallel to the nail base.

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Possible causes : it can be as a result of heavy poisoning from metals such as lead and arsenic, extensive use of manicure, trauma from overly tight footwear, chemotherapy or cirrhosis, e.t.c. Infections like malaria, high fever, leprosy and herpes may also lead to this.

• Longitudinal Leukonychia: an opposite of the leukonychia striata, it is the discoloration that runs lengthwise or vertically on the nails. It is the least common of the types of leukonychia.
  Possible causes: this may be associated with some form of cancer or Darier's disease.

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Prevention and treatment

In most cases, these discolorations are nothing to worry about but we all know it is better to be safe than sorry.

There are two ways to stay "safe"; by prevention and by treatment where you go see a doctor for diagnosis to be certain.

If the white spots are caused by trauma, they naturally grow out with the nails and do not require treatment.

If they are however to be taken more seriously, a doctor will carry out tests for which you may be required to submit clippings of your nails for testing (mycology), opt for a blood test or allow the removal of small tissue for examination (nail biopsy). Kidney and liver functions are examined in some cases and treatment of malnutrition in tune with zinc deficiency and other minerals have been known to bring positive results.

Prevention is better than cure, so you should try to avoid getting to the treatment stage by going easy on the use of nail polish, not biting your nails, avoiding contact with irritant substances, and keeping your nails neat and short.

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I hope this article was very informative to you. Thank you for taking the time to read.

Until next time,
Your favorite Nigerian.😘

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References.

1. Wikipedia | Leukonychia.

2. Have you got white spots on your nails? Turns out it's not from a lack of milk.

3.White spots on nails: causes, prevention and treatment.

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Images were obtained from pixaby and creativecommons

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