Moderate periungual psoriasis with nail ridging will respond to potent topical corticosteroid applied to the affected nail under polyethylene occlusion, used in combination with practical measures to protect the hands such as gloves and avoidance of mechanical or chemical trauma. 12 William Gerstein of Montreal, while training with P. Samman in London, was the first to publish the results of steroid injected into the digit for nail psoriasis.13 Triamcinolone acetonide is the most readily available corticosteroid, the usual concentration is 2. Lastly, the nail unit can, under certain circumstances, be the first sign of a systemic disease in a patient without other manifestations. Open Access Peer-Reviewed Publication of IADVL. The most common histopathologic features associated with trachyonychia are spongiosis and exocytosis of inflammatory cells into the nail epithelia; typical features of lichen planus or psoriasis can also be detected. Trachyonychia was first described by Alkiewicz in 1950 and was termed twenty-nail dystrophy of childhood in 1977 by Hazelrigg, et al. Table 2: Reported treatments for trachyonychia (The following treatments have been cited in the literature for trachyonychia)Click here to viewIn children with TND, a tendency towards spontaneous resolution is seen and one can provide reassurance to parents or to children who are hesitant to have invasive treatments such as corticosteroid injections. London: Blackwell Science; 2001. p. 67-9.
Trachyonychia was first described by Alkiewicz in 1950 and was termed twenty-nail dystrophy of childhood in 1977 by Hazelrigg, et al. The most common histopathologic feature associated with trachyonychia is spongiosis and exocytosis of the inflammatory cells into the nail epithelia. In children with TND, a tendency towards spontaneous resolution is seen and one can provide reassurance to parents or to children who are hesitant to have invasive treatments such as corticosteroid injections. Tosti et al., reported one case of trachyonychia due to psoriasis, which was treated with oral acitretin at a daily dose of 0.3 mg/kg. Nail psoriasis and onychomycosis 5.1 The prevalence of onychomycosis in patients with nail psoriasis; a systematic review. From nine weeks of gestations the first elements of the nail apparatus start to develop, as a transverse ridge on the distal dorsal surface of the digit develops, described as the primary nail field. As shown in Figure 2, the nail plate can be divided into three layers; the dorsal layer, the intermediate (germinative matrix) layer, and the ventral layer. 19 Intralesional corticosteroid injections, injected in the proximal nail fold, have been shown effective in the treatment of predominantly nail matrix lesions. Title: Skinmed v13 i6, Author: jo-ann kalaka-Adams, Name: skinmed_v13_i6, Length: 84 pages, Published: 2016-02-10T00:00:00. 2 Samman PD.