Twenty Nail Dystrophy

Twenty Nail Dystrophy

Key Points
Condition also known as trachyonchia.
Condition characterized by lengthwise grooving, pitting, loss of lustre, and a sand-blasted appearance on the surface of all twenty nails.
Condition more prevalent in young males.
Cause of condition is unknown, but has been associated with other skin conditions.

Twenty-nail dystrophy, also known as trachyonchia, is a condition characterized by longitudinal ridging (lengthwise grooves), pitting, loss of lustre, and roughening (similar to sandpaper) of the nail surface on all twenty nails (fingers and toes). The condition occurs most commonly in childhood, and typically with young males between the ages of 10-20. Typical signs and symptoms include nails becoming rough and brittle or grubby, distortion of nails, longitudinal ridging, pitting, roughening and splitting of nails, a sand-blasted appearance, and discoloration to a muddy, greyish-white color.

The cause of twenty-nail dystrophy is unknown but in some cases it appears to be associated with other skin conditions such as lichen planus, eczema, psoriasis, and alopecia areata.

Differential Diagnosis (Other conditions with similar appearance)
None. May be associated with:
Lichen planus
Eczema
Psoriasis
Alopecia areata

Diagonsis
Key Points
Diagnosed through inspection by medical professional.

Treatment
No specific treatment is available.

There is no specific treatment for twenty-nail dystrophy. It is a very difficult condition to treat and often results are unsatisfactory. Some treatments that have been tried include Griseofulvin and other oral antifungal agents, corticosteroids, and topical PUVA.