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]
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]
^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. ISSN0926-9959. PMID19175482.
^ abKIM, 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. ISSN0385-2407. PMID20536678.
^ abOlszewska, 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. ISSN1175-0561. PMID19354334.
^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. ISSN0007-0963. PMID1419771.
^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. ISSN0385-2407. PMID16471458.