Subtotal Leukonychia

In subtotal leukonychia there is a pink arc of about 2–4 mm in width distal to the white area. Nucleated cells in the distal area were believed to mature, lose their keratohyalin granules and then produce normal nail keratin several months after their formation. It was also suggested that parakeratotic cells are present along the whole length of the nail; these decrease in number as they approach the distal end, thus producing the normal pink colour up to the point of separation from the nail bed. There might, however, be sufficient nucleated onychocytes remaining for the nail to acquire a whitish tint after loss of contact with the nail bed. Some authorities feel that subtotal leukonychia is a phase of total leukonychia based on the occurrence of both types in different members of one family and the simultaneous occurrence in one person. In addition, either type may be found alone in some individuals at different times.

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