True leukonychia: case reports and review of the literature

Leukonychia refers to the whitening of the nail plate. We identified 22 cases reported in the literature. This study presents two cases of idiopathic leukonychia from Saudi Arabia, which, to our knowledge, are the first reported cases in the region. The first case involves a 26-year-old male with a decade-long history of white discoloration affecting all fingernails. He exhibited low vitamin B12 and elevated thyroid-stimulating hormone (TSH) levels. The second case involves a 23-year-old female with asymptomatic white discoloration on five fingernails and a positive family history of leukonychia in her younger brother. This case series contributes to the limited knowledge of true leukonychia and emphasizes the importance of recognizing its benign nature and distinguishing it from other nail disorders.