Saturday, February 18, 2006

From the Nail File

55 year old man with 6 month history of nail distrophy. Only thumbs. He works with his hands cutting film. Trauma likely.

The patient wrote:
"I noticed left thumbnail change in appearance in late August 2005. I scraped the nail down and got fluid near base. The right thumbnail became abnormal after trauma in October of 2005 showing a crack straight up the middle of the nail."

Moderator: I suspect lichen planus. Median nail dystrophy less likely.



  1. This is typical case of post-traumatic dystrophia mediana canaliformis.

  2. This comment has been removed by a blog administrator.

  3. I think that occasionally discoid LE can produce such nail changes. In the Lupus Erythematosus (LE) chapter of the textbook that Tom Provost and I edited, Cutaneous Manifestations of Rheumatic Diseases, are photos of a similr case I saw in an adult black female having typical discoid LE lesions elsewhere on her body. A nailfold biopsy showed changes consistent with discoid LE and/or lichen planus (ie, "lupus planus"). Does the current pt have any clinic or lab evidence of LE?
    --Rick Sontheimer

  4. My FIRST COMMENT was about the first nail case of onycholysis It was by mistake thrown here?????.

    Regarding the present case,the picture is suggestive of a nail lichen planus with characterestic thin frayed nail margin.

  5. I have the same problem. No trauma. Just genetics. My father had it too. I am an MD myself.


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