Median nail dystrophy, also known as dystrophia unguis mediana canaliformis, median canaliform dystrophy of Heller,Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. . and solenonychia consists of longitudinal splitting or canal formation in the midline of the nail, a split which often resembles a

fir tree Firs are evergreen coniferous trees belonging to the genus ''Abies'' () in the family Pinaceae. There are approximately 48–65 extant species, found on mountains throughout much of North and Central America, Eurasia, and North Africa. The genu ...

, occurring at the

cuticle A cuticle (), or cuticula, is any of a variety of tough but flexible, non-mineral outer coverings of an organism, or parts of an organism, that provide protection. Various types of "cuticle" are non- homologous, differing in their origin, structu ...

and proceeding outward as the nail grows.James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. .

Thumb The thumb is the first digit of the hand, next to the index finger. When a person is standing in the medical anatomical position (where the palm is facing to the front), the thumb is the outermost digit. The Medical Latin English noun for thumb ...

s, which are the most commonly involved, usually show an enlarged lunula resulting probably from repeated pressure applied on the base of the nail.

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. Usually symmetrical, the ailment primarily affects the thumbs, though it can also affect other fingers or toes. There may be lunula enlargement, redness, and thickening of the proximal nail fold.

Causes

Although it is an acquired illness, there have been reports of familial clustering of instances. The illness most likely stems from a transient flaw in the matrix that prevents nails from growing. One component that has been identified as causal is trauma.

Diagnosis

Clinical findings are frequently the only basis for diagnosis. Parakeratosis, or the buildup of

melanin Melanin (; ) is a family of biomolecules organized as oligomers or polymers, which among other functions provide the pigments of many organisms. Melanin pigments are produced in a specialized group of cells known as melanocytes. There are ...

inside and between the

keratinocytes Keratinocytes are the primary type of cell found in the epidermis, the outermost layer of the skin. In humans, they constitute 90% of epidermal skin cells. Basal cells in the basal layer (''stratum basale'') of the skin are sometimes refer ...

in the nail bed, is typically seen in

histopathology Histopathology (compound of three Greek words: 'tissue', 'suffering', and '' -logia'' 'study of') is the microscopic examination of tissue in order to study the manifestations of disease. Specifically, in clinical medicine, histopatholog ...

Treatment

For median nail dystrophy, treatment is frequently not required. Normalcy usually returns to affected nails on its own, either when medication is stopped or after a traumatic event.

Triamcinolone acetonide Triamcinolone acetonide, sold under the brand name Kenalog among others, is a synthetic compound, synthetic corticosteroid medication used topical medication, topically to treat various skin conditions, to relieve the discomfort of mouth sores, ...

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.

References

External links

DermNet

VisualDx
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