TRACHYONYCHIA

By Gary M. White, MD

Trachyonychia


Trachyonychia is descriptive term used to describe the nails when they are rough and lack luster. It mimics a nail infection, but is not. The cause may be unknown, or associated with alopecia areata, lichen planus, or psoriasis. Children are typically affected. When all 20 nails are involved, the term 20 nail dystrophy is used.

Clinical

One or multiple nails are rough and lacking in luster. Longitudinal striations, ridges, fissures, or pitting may be present. A fungal culture should be done if the diagnosis is in doubt. A complete skin examination is recommended to exclude cutaneous signs of alopecia areata, psoriasis, lichen planus, vitiligo, and incontinentia pigmenti, etc. In addition, one should make sure there is no inflammation of the skin about the nails as that can cause a chronic nail dystrophy (see chronic paronychia).

Treatment

No treatment is uniformly helpful in idiopathic cases. Improvement occurs in the majority over time and even spontaneous remission may occur [Ped Derm 2015;32;198]. Rarely patients with isolated trachyonychia can later develop psoriasis or alopecia areata.

Additional Pictures

Lackluster nails and pterygium (scarring between the proximal nailfold and the nail matrix) associated with lichen planus
Lackluster nails and pterygium (scarring between the proximal nailfold and the nail matrix) associated with lichen planus.

Nail pitting associated with alopecia areata
Nail pitting associated with alopecia areata.

References

Trachyonychia from lichen planus. Acta Dermato-Venereologica 2015;95;372

RegionalDerm

Homepage | FAQs | Contact Dr. White


It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.