Median nail dystrophy, also known as dystrophia unguis mediana canaliformis, median canaliform dystrophy of Heller,[1]: 657 and solenonychia consists of longitudinal splitting or canal formation in the midline of the nail, a split which often resembles a fir tree, occurring at the cuticle and proceeding outward as the nail grows.[2]: 788
Thumbs, which are the most commonly involved, usually show an enlarged lunula resulting probably from repeated pressure applied on the base of the nail.[1]: 657
Signs and symptoms
Median nail dystrophy presents as gifts that resemble an upside-down fir tree or Christmas tree because to tiny fissures or cracks that break toward the nail edge or extend laterally from the center canal.[3] Usually symmetrical, the ailment primarily affects the thumbs, though it can also affect other fingers or toes.[4] There may be lunula enlargement, redness, and thickening of the proximal nail fold.[5]
Causes
Although it is an acquired illness, there have been reports of familial clustering of instances.[4] The illness most likely stems from a transient flaw in the matrix that prevents nails from growing.[6] One component that has been identified as causal is trauma.[7]
Diagnosis
Clinical findings are frequently the only basis for diagnosis.[8] Parakeratosis, or the buildup of melanin inside and between the keratinocytes in the nail bed, is typically seen in histopathology.[3]
Treatment
For median nail dystrophy, treatment is frequently not required.[8] Normalcy usually returns to affected nails on its own, either when medication is stopped or after a traumatic event.[9][7] Triamcinolone acetonide injected directly into the proximal nail fold or topical ointments have been effectively used in the treatment of median nail dystrophy, though this is not usually advised.[6][10]
See also
References
- ^ a b Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
- ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
- ^ a b Nair, PragyaAshok; Kota, Rahulkrishna; Pilani, Abhishek (2016). "Median nail dystrophy involving the thumb nail". Indian Journal of Dermatology. 61 (1). Medknow: 120. doi:10.4103/0019-5154.174092. ISSN 0019-5154. PMC 4763640. PMID 26955129.
- ^ a b Sweeney, Sarah A; Cohen, Philip R; Schulze, Keith E; Nelson, Bruce R (March 2005). "Familial median canaliform nail dystrophy" (PDF). Cutis. 75 (3): 161–165. PMID 15839359. Retrieved 21 March 2024.
- ^ Wu, C-Y; Chen, G-S; Lin, H-L (2009). "Median canaliform dystrophy of Heller with associated swan neck deformity". Journal of the European Academy of Dermatology and Venereology. 23 (9). Wiley: 1102–1103. doi:10.1111/j.1468-3083.2009.03104.x. ISSN 0926-9959. PMID 19175482.
- ^ a b KIM, Byung Yoon; JIN, Seon Pil; WON, Chong-Hyun; CHO, Soyun (2010-05-24). "Treatment of median canaliform nail dystrophy with topical 0.1% tacrolimus ointment". The Journal of Dermatology. 37 (6). Wiley: 573–574. doi:10.1111/j.1346-8138.2009.00769.x. ISSN 0385-2407. PMID 20536678.
- ^ a b Olszewska, Malgorzata; Wu, John Z.; Slowinska, Monika; Rudnicka, Lidia (2009). "The 'PDA Nail'". American Journal of Clinical Dermatology. 10 (3). Springer Science and Business Media LLC: 193–196. doi:10.2165/00128071-200910030-00006. ISSN 1175-0561. PMID 19354334.
- ^ a b Latham, Lesley; Langley, Richard (2024-03-14). "Answer: Can you identify this condition?". Canadian Family Physician. 59 (5). College of Family Physicians of Canada: 513. PMC 3653657.
- ^ Bottomley, W.W.; Cunliffe, W.J. (1992). "Median nail dystrophy associated with isotretinoin therapy". British Journal of Dermatology. 127 (4). Oxford University Press (OUP): 447–448. doi:10.1111/j.1365-2133.1992.tb00472.x. ISSN 0007-0963. PMID 1419771.
- ^ Grover, Chander; Bansal, Shikha; Nanda, Soni; Reddy, Belum Siva Nagi (2005). "Efficacy of Triamcinolone Acetonide in Various Acquired Nail Dystrophies". The Journal of Dermatology. 32 (12). Wiley: 963–968. doi:10.1111/j.1346-8138.2005.tb00882.x. ISSN 0385-2407. PMID 16471458.
Further reading
- Verma, SB (2008). "Glomus tumor-induced longitudinal splitting of nail mimicking median canaliform dystrophy". Indian Journal of Dermatology, Venereology and Leprology. 74 (3). Scientific Scholar: 257–259. doi:10.4103/0378-6323.41375. hdl:1807/48127. ISSN 0378-6323. PMID 18583797.
- Nayak, Chitra; Madke, Bhushan; Gadkari, Reshma (2012). "Median canaliform dystrophy of Heller". Indian Dermatology Online Journal. 3 (3). Medknow: 224. doi:10.4103/2229-5178.101832. ISSN 2229-5178. PMC 3505440. PMID 23189265.
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