Total leukonychia is characterized by complete whiteness of all nails. The pathogenesis for inherited total leukonychia is a mutation in phospholipase C delta-1 (PLCD1) gene, which encodes a phosphoinositide-specific PLCD1 subunit, an enzyme involved in phosphoinositide metabolism [1]. Pathogenesis in acquired total leukonychia has been hypothesized to be neurovascular deterioration and edema of the fingers causing chronic trauma to the nail matrix [2].