Differential Diagnosis for White Spots Under Fingernail
Single Most Likely Diagnosis
- Leukonychia: This condition is characterized by white spots or patches under the fingernails, often due to minor trauma, nail biting, or exposure to certain chemicals. It's a common and usually benign condition.
Other Likely Diagnoses
- Nail Fungal Infection (Onychomycosis): While more commonly associated with discoloration, thickening, or brittleness of the nails, some fungal infections can cause white spots under the nail.
- Nail Psoriasis: Psoriasis can affect the nails, leading to various changes, including white spots under the nail due to the accumulation of keratin debris.
- Trauma: Direct injury to the nail bed can cause white spots to appear under the nail as the nail grows out.
Do Not Miss Diagnoses
- Systemic Lupus Erythematosus (SLE): Although rare, SLE can cause a variety of nail changes, including white spots under the nails, as part of its broader spectrum of systemic symptoms.
- Sarcoidosis: This condition can affect multiple parts of the body, including the skin and nails, potentially causing white spots under the nails among other nail abnormalities.
Rare Diagnoses
- Terry's Nails: A condition where the nails appear white with a characteristic "ground glass" appearance, often associated with liver disease or other systemic conditions.
- Darier's Disease: A rare genetic disorder that affects the skin and sometimes the nails, potentially causing white or red spots under the nails.
- Sjögren's Syndrome: An autoimmune disorder that can cause dryness in the eyes, mouth, and other areas, and may also lead to nail changes, including white spots under the nails, though this is less common.