By Gary M. White, MD

Median nail dystrophy

Median nail dystrophy (MND) is a benign change of the nail in which a longitudinal ridge forms down the center of the nail.


The thumb (one or both) is most commonly affected. A longitudinal ridge forms down the center of the nail. Sometimes transverse ridges occur, making the overall appearance that of a fir tree.


No therapy is reliably effective. The habit tic deformity has a similar appearance and should be excluded as that condition can be improved by having the patient refrain from picking at the nail.

Additional Pictures

Median nail dystrophy


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