Trachyonychia in childhood: Clinical aspects and outcome

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Published Nov 18, 2023
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Vol. 101 No. 10 (2023): Tunis med oct 2023

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Marouene Rahmouni
Department of Dermatology , Habib Thameur Hospital, Tunis / Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Talel Badri
Department of Dermatology , Habib Thameur Hospital, Tunis / Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia

Abstract

Introduction : Trachyonychia means rough, longitudinally ridged nails with a sandy, brittle and thin aspect. It is a rare condition that occurs mainly in children. Studies on trachyonychia are rare.


Aim: To describe the clinical aspects and outcome of trachyonychia, as well as its treatment.


Methods: We studied three cases of trachyonychia in childhood seen at the outpatient clinic, and performed a literature review on the same subject.


Cases: Two boys aged 11 and 14 years old and a girl aged 6 years presented with nail dystrophy of the fingers and toes. Patient 1 had also a scaly patch on the glans penis, and patient 2 was atopic. Trachyonychia associated with psoriasis was suspected in patient 1 and the idiopathic form was retained in the other two patients. All patients were treated with topical steroids for a few months. The patients did not show any improvement at the six-month follow-up. Only one patient was contacted again after two years and showed spontaneous healing.


Commentaries: The diagnosis of trachyonychia is mainly clinical. In the literature, 62% of pediatric patients had an idiopathic form. However, a strong association was observed between trachyonychia and alopecia areata. Trachyonychia of childhood appears to have a good prognosis, with spontaneous improvement within six months to two years. Therapeutic abstention is the rule.

Keywords:

Trachyonychia, Trachyonychia of childhood, Twenty nails dystrophy, Sandpaper nails

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References

  1. Alkiewicz J. Trachyonychie. Ann Dermatol Syphiligr. 1950;10:136-40.
  2. Hazelrigg DE, Duncan WC, Jarratt M. Twenty-nail dystrophy of childhood. Arch Dermatol. 1977;113:73-5.
  3. Oyeleke BS, Shekwonyadu KI. Twenty-nail-dystrophy / trachyonychia: a case report in a five year old girl seen at the paediatric out-patient department of a tertiary hospital in Lafia North-Central Nigeria. Pan Afr Med J. 2020;36:380.
  4. Dogruk Kacar S, Ozuguz P, Polat S. Coexistence of psoriasis, and alopecia areata with trachyonychia in a pediatric patient with Turner Syndrome. Arch Argent Pediatr. 2014;112:e209-12.
  5. Haber JS, Chairatchaneeboon M, Rubin AI. Trachyonychia: review and update on clinical aspects, histology, and therapy. Skin Appendage Disord. 2016;2:109-15.
  6. Baran R, Dawber R. Twenty-nail dystrophy of childhood: a misnamed syndrome. Cutis. 1987;39:481-2.
  7. Scheinfeld NS. Trachyonychia: a case report and review of manifestations, associations, and treatments. Cutis. 2003;71:299-302.
  8. Commens CA. Twenty nail dystrophy in identical twins. Pediatr Dermatol. 1988;5:117-9.
  9. Bibb LA, Chang MW. Simultaneous occurrence of idiopathic trachyonychia in dizygotic twins. Pediatr Dermatol. 2021;38:1586-7.
  10. de Berker DAR, Richet B, Baran R. The nail in chilhood and old age. In: Baran R, de Berker DAR, Holzberg M, Thomas L, dir. Baran & Dawber’s Diseases of the Nails and their Management. Hoboken: Wiley-Blackwell; 2012. p. 183-209.
  11. Tosti A, Piraccini BM, Iorizzo M.: evaluation and treatment plans. Dermatol Ther. 2002;15:121-5.
  12. Jacobsen AA, Tosti A. Trachyonychia and twenty-nail dystrophy: A comprehensive review and discussion of diagnostic accuracy. Skin Appendage Disord. 2016;2:7-13.
  13. Tosti A, Bardazzi F, Piraccini BM, Fanti PA, Cameli N, Pileri S. Is trachyonychia, a variety of alopecia areata, limited to the nails? J Invest Dermatol. 1995;104:27S-8S.
  14. Takeuchi Y, Iwase N, Suzuki M, Tsuyuki S. Lichen planus with involvement of all twenty nails and the oral mucous membrane. J Dermatol. 2000;27:94-8.
  15. Schissel DJ, Elston DM. Topical 5-fluorouracil treatment for psoriatic trachyonychia. Cutis 1998;62:27-8.
  16. Mahajan R, Kaushik A, De D, Handa S. Pediatric trachyonychia- A retrospective study of 17 cases. Indian J Dermatol. 2021;66:689-90.
  17. Kumar MG, Ciliberto H, Bayliss SJ. Long-term follow-up of pediatric trachyonychia. Pediatr Dermatol. 2015;32:198‑200.
  18. Taniguchi S, Kutsuna H, Tani Y, Kawahira K, Hamada T. Twenty-nail dystrophy (trachyonychia) caused by lichen planus in a patient with alopecia universalis and ichthyosis vulgaris. J Am Acad Dermatol. 1995;33:903-5.
  19. Peloro TM, Pride HB. Twenty-nail dystrophy and vitiligo: A rare association. J Am Acad Dermatol. 1999;40:488-90.
  20. Scardamaglia L, Howard A, Sinclair R. Twenty-nail dystrophy in a girl with incontinentia pigmenti. Australas J Dermatol. 2003;44:71-3.
  21. Leong AB, Gange RW, O’Connor RD. Twenty-nail dystrophy (trachyonychia) associated with selective IgA deficiency. J Pediatr. 1982;100:418-20.
  22. Norton SA, Demidovich CW. Down syndrome, alopecia universalis, and trachyonychia. Pediatr Dermatol. 1993;10:187-8.
  23. Tosti A, Fanti PA, Morelli R, Bardazzi F. Trachyonychia associated with alopecia areata: a clinical and pathologic study. J Am Acad Dermatol. 1991;25:266‑70.
  24. Grover C, Khandpur S, Reddy BSN, Chaturvedi KU. Longitudinal nail biopsy: utility in 20-nail dystrophy. Dermatol Surg. 2003;29:1125‑9.
  25. Leung AKC, Lam JM, Leong KF, Hon KL, Barankin B, Leung AAM, et al. Onychomycosis: an updated review. Recent Pat Inflamm Allergy Drug Discov. 2020;14:32‑45.
  26. Lee YB, Cheon MS, Eun YS, Cho BK, Park YG, Park HJ. Cyclosporin administration improves clinical manifestations and quality of life in patients with 20-nail dystrophy: Case series and survey study. J Dermatol. 2012;39:1064-5.
  27. Park JM, Cho HH, Kim WJ, Mun JH, Song M, Kim HS, et al. Efficacy and safety of calcipotriol/betamethasone dipropionate ointment for the treatment of trachyonychia: An open-label study. Ann Dermatol. 2015;27:371-5.
  28. Khoo BP, Giam YC. A pilot study on the role of intralesional triamcinolone acetonide in the treatment of pitted nails in children. Singapore Med J. 2000;41(2):66-8.
  29. Mittal R, Khaitan BK, Sirka CS. Trachyonychia treated with oral mini pulse therapy. Indian J Dermatol Venereol Leprol. 2001;67:202-3.
  30. Möhrenschlager M, Schmidt T, Ring J, Abeck D. Recalcitrant trachyonychia of childhood – response to daily oral biotin supplementation: report of two cases. J Dermatol Treat. 2000;11:113-5.