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Nail Disorders in Children With Down Syndrome: A Multicenter Study.

Sezgi Sarikaya Solak1, Filiz Cebeci Kahraman2, İsa An3

  • 1Department of Dermatology, Faculty of Medicine, Trakya University, Edirne, Türkiye.

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|March 10, 2026
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Summary

Nail disorders are common in children with Down syndrome (DS), affecting over half of those studied. Early identification of these conditions can help manage associated health issues in DS patients.

Keywords:
Beau's linesDown syndromebrittle nailschildrennail disordersonychophagiaonychothillomania

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Area of Science:

  • Dermatology
  • Pediatrics
  • Genetics

Background:

  • Skin conditions in Down syndrome (DS) are known, but nail disorders are less understood.
  • This study addresses the under-researched area of nail abnormalities in children with DS.

Purpose of the Study:

  • To determine the prevalence of nail disorders in children with Down syndrome.
  • To describe the clinical characteristics of these nail disorders.

Main Methods:

  • A multicenter, case-control study involving 221 children with DS and 160 healthy controls.
  • Expert dermatological examination of nails and skin was conducted across 9 tertiary centers.

Main Results:

  • Over half of children with DS (57%) exhibited at least one nail disorder, significantly more than controls.
  • Common disorders included brittle nails (19%), Beau's lines/onychomadesis (16.3%), longitudinal ridging (12.7%), and self-induced disorders (10%).
  • Children with DS had a 3x higher risk of any nail disorder, with specific conditions showing even greater risk increases.

Conclusions:

  • Nail disorders are prevalent in children with Down syndrome.
  • Identifying these nail issues may help detect underlying systemic or psychiatric conditions.
  • Comprehensive care for children with DS can be improved through recognizing nail abnormalities.