True leukonychia results from defective keratinization of the distal matrix with persistence of parakeratotic cells in the ventral nail plate. The superficial nail plate is structurally normal, but the nail presents opaque white patches or striae, which often disappear before reaching the distal edge of the nail. Punctate leukonychia is due to microtrauma and is typically seen in the fingernails of children. Striate leukonychia of fingernails is a consequence of aggressive manicure. Total or subtotal leukonychia is usually hereditary