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Twenty nail dystrophy in identical twins.

¹Skin and Cancer Foundation, Westmead, NSW, Australia.

Pediatric Dermatology

|May 1, 1988

Summary

Identical twins with lifelong twenty nail dystrophy showed no other skin issues and did not respond to treatments. This suggests twenty nail dystrophy might stem from localized tissue malformation, not skin diseases.

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Area of Science:

Dermatology
Genetics
Pediatrics

Background:

Twenty nail dystrophy (TND) is a common nail disorder of childhood.
The etiology and pathogenesis of TND remain largely unknown.
Previous hypotheses have linked TND to autoimmune conditions or nutritional deficiencies.

Observation:

This report details a case of identical female twins presenting with lifelong twenty nail dystrophy since early childhood.
The twins exhibited no other cutaneous manifestations or systemic health issues.
The nail dystrophy remained stable and unresponsive to various therapeutic interventions over time.

Findings:

The persistent and benign clinical course of TND in these twins challenges its association with inflammatory or autoimmune skin diseases like lichen planus.
The lack of response to treatment further supports a non-inflammatory etiology.
A localized tissue malformation, similar to inflammatory linear verrucous epidermal nevus, is proposed as a potential cause for TND in childhood.

Implications:

This case suggests TND may represent a distinct entity, possibly a localized developmental anomaly of the nail apparatus.
Further research into the genetic and developmental factors underlying TND is warranted.
Understanding the specific etiology could lead to more targeted and effective management strategies for twenty nail dystrophy.

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