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Long-term follow-up of pediatric trachyonychia
Monique G Kumar1, Heather Ciliberto, Susan J Bayliss
1Division of Dermatology, Department of Internal Medicine, School of Medicine, Washington University, St. Louis, Missouri.
Insights
Pediatric trachyonychia, an acquired nail condition, often presents in childhood. Most cases are isolated and show improvement over time, even without specific treatment.
Area of Science:
- Dermatology
- Pediatric Medicine
- Nail Diseases
Background:
- Pediatric trachyonychia is an acquired nail disorder affecting children.
- The condition is poorly understood, with limited long-term follow-up data.
- It can cause significant distress for affected families.
Purpose of the Study:
- To review long-term outcomes of children diagnosed with isolated pediatric trachyonychia.
- To assess the natural history and treatment effectiveness for this condition.
- To provide insights into the prognosis of pediatric trachyonychia.
Main Methods:
- An institutional review of 11 children diagnosed with pediatric trachyonychia.
- Patients were followed over time, with photographic documentation and questionnaires.
- Exclusion criteria ensured focus on isolated trachyonychia, ruling out other causes of nail dystrophy.
Main Results:
- The mean age of onset was 2.7 years, with an average follow-up of 66 months.
- Most patients (82%) showed improvement in nail appearance at follow-up.
- Improvement was observed regardless of treatment, with topical corticosteroids, petrolatum, or vitamin supplements used in some cases.
Conclusions:
- The majority of pediatric trachyonychia cases are isolated and tend to improve spontaneously over time.
- Long-term follow-up suggests a generally favorable prognosis for isolated pediatric trachyonychia.
- Further research may clarify specific treatment efficacies, though natural resolution appears common.
Abstract:
Pediatric trachyonychia is an acquired nail disease that can cause distress to families. It is a poorly understood disease, and long-term follow-up data are lacking. We present an institutional review of 11 children with isolated pediatric trachyonychia followed over time. Children with the diagnosis of pediatric trachyonychia were identified and invited to participate. Pictures were taken on follow-up and a questionnaire was answered. Exclusion criteria include having another diagnosis at the initial visit that causes nail dystrophy. Eleven patients with the diagnosis of pediatric trachyonychia were available for follow-up. The mean age of appearance was 2.7 years (range 2-7 yrs) and the average follow-up was 66 months (range 10-126 mos). Nine patients were treated with potent topical corticosteroids, one used only petrolatum, and one took vitamin supplements. One patient was found to have an additional skin and hair diagnosis of alopecia areata on follow-up. On follow-up, 82% noted improvement of the nails, whereas 18% noted no change. A majority of cases of pediatric trachyonychia are isolated and improve with time, regardless of treatment.
