CASE REPORT


Unilateral Transverse Leukonychia in a Patient Receiving Isotretinoin Treatment with Concomitant Renal Impairment: A Case Report



Mohammed Saud Alsaidan1, *
1 Department of Internal Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, AlKharj 1942, Saudi Arabia


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Creative Commons License
© 2023 Mohammed Saud Alsaidan

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Internal Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; Tel: +966115886144, +966551113300; E-mails: dr.saidan@hotmail.com, m.alsaidan@psau.edu.sa


Abstract

Aims:

Leukonychia is a white discoloration of nails. Although it is usually clinically insignificant, it can serve as a clue for systemic diseases that is sometimes life-threatening.

Case Report:

A 24-year-old male patient, with resistant acne vulgaris not responding to topicals nor systemic antibiotics and with a history of renal impairment and untreated recurrent high blood pressure readings, was started on isotretinoin. Three months later, he presented with a unilateral true transverse leukonychia with a worsening renal impairment. The patient was started on antihypertensive medications. The patient was seen two months later with unilateral transverse leukonychia fading (moving distally).

Results:

Repeated laboratory tests showed slightly increased serum creatinine, improved but still high protein/creatinine ratio. The fading of leukonychia while continuing isotretinoin treatment and after starting antihypertensive medication that has a renal protective effect may indicate a renal-associated leukonychia.

Conclusion:

This is probably the first reported unilateral leukonychia without identified local/unilateral causes.

Keywords: Leukonychia, Unilateral, Transverse, Isotretinoin, Renal impairment, Case report.