Differential Diagnosis for White Spots on Nail Bed
Single Most Likely Diagnosis
- Leukonychia: This condition is characterized by the appearance of white spots or patches on the nails due to air bubbles or other abnormalities in the nail plate. It is often caused by minor trauma to the nail bed and is usually benign.
Other Likely Diagnoses
- Nail Fungal Infection (Onychomycosis): Fungal infections can cause changes in the nail's appearance, including white spots or patches, especially if the infection is caused by a yeast.
- Nail Psoriasis: Psoriasis can affect the nails, leading to various changes, including white spots due to the formation of pits or other abnormalities in the nail plate.
- Trauma: Direct trauma to the nail can cause white spots due to the formation of blood blisters or other damage to the nail bed.
Do Not Miss Diagnoses
- Systemic Lupus Erythematosus (SLE): Although rare, SLE can cause nail changes, including white spots, as part of its broader spectrum of symptoms affecting various body systems.
- Sarcoidosis: This condition can also lead to nail changes, including white spots, due to granulomatous infiltration of the nail bed.
Rare Diagnoses
- Terry's Nails: A condition where the nails appear white due to a decrease in the blood flow and an increase in the connective tissue in the nail bed, often associated with liver disease or other systemic conditions.
- Half-and-Half Nails: Characterized by a white proximal half and a red or brown distal half of the nail, often associated with chronic kidney disease or other systemic conditions.