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[Trachyonychia: 20-nail dystrophy]

O Braun-Falco, M Dorn, U Neubert

    Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, Und Verwandte Gebiete
    |January 1, 1981
    PubMed
    Summary
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    Trachyonychia, or 20-nail dystrophy, is a nail condition with multiple causes. Nail bed biopsies are crucial for diagnosing trachyonychia, distinguishing it from other nail disorders.

    Area of Science:

    • Dermatology
    • Pathology
    • Nail Disorders

    Background:

    • Trachyonychia presents as a non-specific nail abnormality, often termed 20-nail dystrophy.
    • It is recognized as a symptom of various underlying conditions, including psoriasis, lichen planus, alopecia areata, and atopic dermatitis.
    • Accurate diagnosis is essential to differentiate trachyonychia from other nail dystrophies.

    Observation:

    • This study describes four patients with trachyonychia using clinical, histological, and scanning electron microscopy.
    • The patients presented with nail changes suggestive of trachyonychia.
    • Diagnostic exclusion of psoriasis vulgaris and lichen planus was performed clinically and histologically.

    Findings:

    • Trachyonychia is confirmed as a polyetiological symptom, meaning it can arise from diverse causes.

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  • Histological examination revealed spongiotic dermatitis of the nail matrix and nail bed.
  • Column-like parakeratosis within the nail plate was observed in cases associated with alopecia areata, atopic dermatitis, and idiopathic forms.

    • Implications:

    • Nail bed biopsies are critical for accurate diagnosis of trachyonychia.
    • Understanding the diverse etiologies of trachyonychia aids in clinical management.
    • Histopathological findings, such as spongiotic dermatitis and column-like parakeratosis, are key diagnostic markers.