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.

Comments??

5 comments:

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

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

    ReplyDelete
  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

    ReplyDelete
  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.
    KHALIFA SHARQUIE

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

    ReplyDelete

We welcome your comments. We endeavor to serve your patients and you. If you want us to respond, please add your name and email address. Some people have trouble uploading comments. In that case, please send comments directly to djelpern@gmail.com. Thank you.