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Twenty nail dystrophy
Other namesSandpapered nails[1][2]
SpecialtyDermatology Edit this on Wikidata

Trachyonychia, is a condition characterized by rough accentuated linear ridges (longitudinal striations) on the nails of the fingers and toes.[3] When the condition occurs on all the twenty nails of the fingers and toes, it is known as twenty-nail dystrophy, most evident in childhood,[4] favoring males.[2][5]

Trachyonychia causes the nails to become opalescent, thin, dull, fragile, and finely longitudinally ridged, and, as a result, distally notched.[6] It can be a manifestation of lichen planus, psoriasis, alopecia areata, immunoglobulin A deficiency, atopic dermatitis, and ichthyosis vulgaris.[7]

"The longitudinal striations can occur as a normal part of the aging process",[2] and not until the nails start to thin and get a sandpaper look is the condition called trachonychia. The nails are opalescent and frequently are brittle and split at the free margin. There has been evidence of the condition as a cutaneous manifestation of lichen planus. It has also been associated with other diseases such as eczema, psoriasis, alopecia areata, and atopic dermatitis.[2] Trachonychia is often seen in vitiligo patients – suggesting that they are more susceptible to this condition.[2]


  1. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  2. ^ a b c d e Fawcett, Ronald S.; Hart, Thomas M.; Linford, Sean;Stulberg, Daniel L. (2004)."Nail Abnormalities: Clues to Systemic Disease". American Family Physician 69(6): 1417-1424
  3. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  4. ^ "Twenty-nail dystrophy | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". Retrieved 2018-04-17.
  5. ^ Scheinfeld NS (April 2003). "Trachyonychia: a case report and review of manifestations, associations, and treatments". Cutis. 71 (4): 299–302. PMID 12729094.
  6. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  7. ^ Scheinfeld NS. Trachyonychia: a case report and review. Cutis. 2003;71:299-302. "PMID 12729094"

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