Leukonychia is defined as white discoloration of the nail(s). Leukonychia is classified into five morphologic presentations, including punctate leukonychia, transverse leukonychia, longitudinal leukonychia, partial leukonychia, and total leukonychia [1]. Leukonychia is further classified by the involved anatomical structure [2]. Apparent leukonychia occurs due to changes in the nail bed, true leukonychia occurs due to pathology in the nail matrix or nail plate, and pseudoleukonychia involves only the surface of the nail plate [1]. As a general diagnostic principle, the white discoloration in apparent leukonychia disappears with pressure and does not move distally with nail growth. On the other hand, the white discoloration in true leukonychia and pseudoleukonychia does not disappear with pressure and moves distally with nail growth. It is helpful to keep these principles in mind when evaluating a patient with leukonychia, in order to identify the anatomic region that is pathologic. Punctate leukonychia is characterized by white spots on the nail(s). The most common subtype of punctate leukonychia is punctate true leukonychia, followed by punctate pseudoleukonychia [1].