Trachyonychia

Characteristics

Trachyonychia is a benign inflammation of the nail matrix. It can occur regardless of gender and at any age, but children are most commonly affected. Trachyonychia occurs on both fingernails and toenails. As a result of the condition, the nail becomes thickened, grayish-white, rough, covered with numerous tiny scales, and resembles sandpaper to the touch. Sometimes the roughness of the nail is accompanied by concave nail plate. In advanced cases, the nail may deform, delaminate and break. When the condition involves all the fingernails and toenails and the cause is unknown, it is called "twenty nail dystrophy" (TND). In many Patients, nail changes associated with trachyonychia resolve spontaneously. In children, the disease lasts shorter than in adults, and among adults, it resolves more rapidly in men.

Causes

The causes of trachyonychia are not fully understood, but dermatologists most often point to a genetic basis and the presence of comorbidities. Conditions that can lead to rough nails include lichen planus, atopic dermatitis, eczema, psoriasis and alopecia areata. In cases where both causes are excluded, we speak of idiopathic form of rough nails. This means that the disease occurs spontaneously and the underlying cause cannot be determined. Some studies suggest that trachyonychia may also be caused by chemotherapy. However, the most common causes of the condition are psoriasis and atopic dermatitis.

Types

We can divide trachyonychia based on its appearance and clinical course:

• Non-transparent trachyonychia – occurs more frequently and has a more severe clinical course. As a result, the nails are dull, thickened, and look like they have been rubbed with sandpaper.
• Glossy Trachyonychia – occurs less frequently and is therefore more difficult to diagnose. The nails retain their shine and reflect light, but are covered with shallow, very numerous cavities. Glossy Trachyonychia is most often associated with alopecia areata.

Diagnostics

If you notice symptoms of trachyonychia in yourself, see a dermatologist immediately. The most important factor in treating the condition is to determine its cause, so during your history, your physician will ask you about your medical conditions and the drug therapy you are taking. If your known medical history does not predispose you to the condition, your physician may recommend additional examinations. Your physician will perform a thorough examination of your nails, skin, mucous membrane, and hair. Because trachyonychia is similar to onychomycosis and psoriasis, your specialist may perform examinations to rule out these conditions. Although the symptoms of trachyonychia are characteristic, you should not diagnose the disease on your own. A visit to an experienced dermatologist is necessary to diagnose the condition and implement optimal treatment.

Treatment methods

Trachyonychia, although harmless to health, can be a serious cosmetic defect and affect the well-being of the affected person. If trachyonychia is caused by another disease, its treatment is based on alleviating or curing the existing condition. In cases where the condition is associated with onychomycosis or psoriasis, treatment specific to those conditions is necessary. If the trachyonychia has occurred concurrently with a deterioration in general health, treatment of trachyonychia must be combined with diagnosis of the potential disease and its stabilization or cure. In all of the above cases, as well as in idiopathic trachyonychia, the dermatologist may recommend topical agents including urea creams, corticosteroids and retinoids, as well as oral agents based on acitretin, biotin or cyclosporine, among others.

If you notice any unusual changes in your hands or toenails, or you are concerned about the condition of your nails, we invite you to a professional dermatological consultation, during which we diagnose the problem and present available treatment methods.

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