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Infections: Bacterial, viral, and parasitic infections may cause leukonychia, including HIV.

Hormones: Leukonychia is known to appear as a result of menstrual hormones.

Drugs: Certain drugs, including the immunosuppressive drug cyclosporine, chemotherapy drugs, and retinoids can result in leukonychia.

Zinc or selenium deficiency: People who don't get enough zinc or selenium in their diet can develop leukonychia.

Skin diseases: Leukonychia is seen in skin diseases like psoriasis, alopecia areata, and vitiligo.

Blood disorders: Acute myeloid leukemia, Hodgkin's disease, and sickle cell anemia have been linked to leukonychia.

Neurovascular disorders: Epilepsy has been linked to leukonychia.

Nail trauma: Trauma to the nail and cuticle due to pressure on the nail plate, as well as irritating nail cosmetics, can cause the nail to become fragile.

Drug use: Drugs associated with transverse or longitudinal melanonychia include chemotherapy drugs, drugs used to treat HIV, immunosuppressive drugs like chloroquine, and fluconazole, which is used to treat fungal infections.

Cuticle trauma: Chronic biting, chewing, or picking at the cuticle can trigger melanocytes to diffuse into the nail bed, which may result in total or longitudinal melanonychia.

Systemic diseases: Total or banded melanonychia is linked to such diseases as Addison's disease, Cushing's syndrome, hyperthyroidism, acromegaly, and AIDS.

Tumors: Longitudinal melanonychia can be a sign of certain cancers, such as onychomatricoma (cuticle tumor), squamous cell carcinoma, and basal cell carcinoma.

Inflammatory disorders: Longitudinal melanonychia has been linked to psoriasis, lichen planus, chronic paronychia, and other inflammatory disorders that affect the skin and nails.Nutritional deficiencies: Vitamin D, vitamin B12, and protein deficiencies are known to cause longitudinal or total melanonychia.Infections: Fungal, bacterial, and viral infections, particularly HIV, may result in longitudinal or transverse melanonychia.The discoloration may resolve or persist following delivery.

Pregnancy: Longitudinal melanonychia is associated with pregnancy.