Differential Diagnosis for White Spots on Fingernails
Single Most Likely Diagnosis
- Leukonychia: This condition is characterized by white spots or patches on the nails, often due to minor trauma, nail biting, or other forms of nail injury. It's common in children and usually benign.
Other Likely Diagnoses
- Nail Trauma: Direct injury to the nail can cause white spots due to the formation of keratin deposits.
- Fungal Infections: While less common, fungal infections like onychomycosis can cause white spots or discoloration on the nails.
- Nutritional Deficiencies: Deficiencies in vitamins like B7 (biotin) or minerals can affect nail health, potentially leading to white spots.
- Idiopathic Leukonychia: Some cases of leukonychia have no identifiable cause and are considered idiopathic.
Do Not Miss Diagnoses
- Systemic Lupus Erythematosus (SLE): Although rare in children, SLE can cause a variety of nail changes, including white spots, and is a condition that should not be missed due to its serious implications.
- Terry's Nails: Associated with liver disease, these nails can appear white due to a decrease in the nail bed's vascularity, but this would typically be accompanied by other signs of liver disease.
- Sarcoidosis: A rare condition that can affect multiple systems, including the skin and nails, causing various abnormalities.
Rare Diagnoses
- Darier's Disease: A rare genetic disorder that affects the skin and sometimes the nails, causing white or pinkish lesions.
- Tuberous Sclerosis Complex (TSC): A genetic disorder that can cause a variety of skin and nail abnormalities, including white spots on the nails.
- Nail Psoriasis: While psoriasis is more commonly associated with skin lesions, it can also affect the nails, causing pitting, thickening, or white spots.