Terry’s nails

A 28-year-old man presented with whitish discolouration of nails since childhood with no family history. Examination revealed leukonychia of proximal three-fourth of the nail plate with sparing of a narrow distal brownish-pinkish band [Figure 1]. Whiteness of nails was unaffected by pressure application. Complete haemogram, liver and kidney function tests, urine microscopy, and glucose levels were normal. It was diagnosed as a case of Terry’s nails. Terry’s nails are a form of apparent leukonychia and various mechanisms have been postulated including abnormal metabolism of steroids and alterations in the nail bed vascularity. It may be associated with disorders such as liver cirrhosis, heart failure, and haematologic disease etc. However, we did not find any cause in our patient. Lindsay’s nails (indicative of renal disease) must be differentiated from Terry’s nails as the former shows a split half-and-half appearance of the nail plate.

Terry’s nails showing subtotal leukonychia of the proximal nail plate with a narrow (<20%) distal brownish-pinkish band of fingernails. Figure 1: Terry’s nails showing subtotal leukonychia of the proximal nail plate with a narrow (<20%) distal brownish-pinkish band of fingernails.

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