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Trachyonychia “Rough Nail “: Causes, Symptoms, Diagnosis, And Treatment.

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Trachyonychia “Rough Nail “: Causes, Symptoms, Diagnosis, And Treatment.

What is Trachyonychia

Trachyonychia is a dystrophic process in the nail plate, characterized by changes in its color and structure. The symptom accompanies many dermatological diseases (eczema, psoriasis, fungal lesions, and others) and the pathology of other systems. Often this disease occurs in children, it has a very severe course. What is trachyonychia and how is it treated?

Trachyonychia is also known as twenty-nail dystrophy and includes rough, rough nails that are brittle and thin. trachyonychia term was used in 1950 by alkivitz until the condition was described by Hazelrigg et al. in 1977 as twenty-nail dystrophy Nevertheless, the term twenty-nail dystrophy is misleading because in trachyonychia any number of nails can be involved in the pathological process and on the other hand, common nail dystrophy is often misdiagnosed as twenty-nail dystrophy, even when the clinical signs of trachyonychia are not obvious. It is for this reason that we have given an extensive review of the clinical signs of trachyonychia and additionally added a discussion regarding the diagnostic accuracy of determining this condition.

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Trachyonychia Causes

What causes Trachyonychia?

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The process is multifactorial, but it is based on a disturbance of the nail plate nutrition, which is accompanied by a defect in keratin formation. All causes of trachyonychia can be divided into several main groups:

  • Immune system disorders. In immune system disorders, lymphocytes attack their own cells, including endotheliocytes lining the inner surface of capillaries. This leads to disruption of the supply of nutrients and oxygen to the nails.
  • Endocrinological disorders. Diabetes mellitus deficiency or excess of thyroid hormones leads to capillary dysfunction and therefore nutrient deficiency in the nail matrix.
  • Atherosclerosis. In the presence of atherosclerotic plaque on the inner surface of the vessels, oxygen delivery to keratinocytes is impaired, which manifests as trachyonychia.
  • Injuries. Violation of the manicure technique leads to delamination of the nail plate and its subsequent improper formation.
  • Dermatological diseases. Trachyonychia, or "sandy" nails, accompanies such pathological processes as eczema, psoriasis of the nails, red lichen planus, neurodermatitis, and others.
  • Idiopathic trachyonychia. No specific cause for this type of trachyonychia has been found. It usually begins in early childhood and is poorly treated. It affects the nails on both the hands and feet.

Trachyonychia in children

Congenital trachyonychia occurs in the first year of life or slightly later. In a child, a thickening of the nail plate and a pitted and "perforated" surface of the nail, characteristic of trachyonychia, is revealed.

The idiopathic process is difficult to treat, so masking agents and preparations are used to strengthen the nail plate.

Classification

It can be in two versions:

  • Idiopathic. In this case, it develops as a result of an allergic reaction to some exogenous causative factor - an allergen. Refers to congenital species. Here, the genetic predisposition to this type of dystrophic phenomena against the background of an allergic reaction is of great importance.
  • Symptomatic. This option takes place with the development of pathological conditions in the body - psoriatic and eczematous damage, neurodermatitis, lichen planus, alopecia areata.

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Trachyonychia Symptoms

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What are the Symptoms of Trachyonychia?

In trachyonychia, the nails have a number of characteristic features:

  • The nail plate becomes dense and thick due to increased keratin formation and impaired keratin rejection. This process also occurs in congenital pachyonychia.
  • The outer part of the plate loses its characteristic shine, becomes rough to the touch.
  • On the nail, there are often dots - indentations of the plate inside, as if the surface was poked with a needle or awl.
  • Due to dysfunction and increased capillary brittleness, a painful subungual hematoma forms.
  • Increased nail brittleness leads to the appearance of fractures and splitting of the protruding part of the nail.
  • The shape of the nail plate also changes; it becomes concave, like a spoon. This process is called koilonychia.
  • The soft tissues around the nail and the bone are not damaged.

Trachyonychia Diagnosis

How is Trachyonychia diagnosed?

To determine the correct tactics for treating trachyonychia, they are looking for the cause of the disease. The examination begins with a close examination of the damaged structures, a piece of the nail plate is analyzed under a microscope to isolate fungi and other possible pathogens.

In addition, the history of the development of the disease is analyzed and a complete examination is carried out to exclude the pathology of a non-dermatological nature.

An important role is played by the histological examination of a piece of the periungual structures and the matrix of the nail. With trachyonychia, slight edema and pathological formation of keratin are revealed.

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Trachyonychia Treatment

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How is Trachyonychia treated?

Therapeutic measures for trachyonychia are carried out in two main directions:

  • Treatment of the underlying disease that caused the disruption of keratin formation and changes in the nails.
  • Correction of metabolism.

The complexity of basic measures depends on the type of disease. So, for psoriasis, ointments based on glucocorticosteroids and preparations with the addition of retinoids and vitamin D are used.

Vitamin complexes and mineral supplements are prescribed as strengthening measures. Physiotherapeutic procedures are effective: phonophoresis with calcium and other minerals.

To quickly improve the condition, it is recommended to cut nails short, use protective equipment when working with chemicals and on the ground. It is undesirable to use acetone-based varnishes and solvents, as they severely injure the nail plate.

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Treatment with folk methods

Alternative methods of treatment are recommended to be used in combination with therapy for the underlying cause of nail disease. Apply:

  • Sea buckthorn oil or rosehip oil. The oil is rubbed into the damaged nail plate every day 2-3 times a day for 2 months.
  • Oatmeal mask. Oatmeal is ground with a coffee grinder or other device. Then the resulting flour is diluted in a small amount of boiled water to a homogeneous mushy mass. Porridge is applied to the nails every day in the evening for a month, the duration of the procedure is 20 minutes. After the mask, sea buckthorn oil, nourishing cream, or vitamin A solution are rubbed into the nails.

Prevention of Trachyonychia of nails

Preventive measures are reduced to good nutrition, the implementation of the correct manicure technique, as well as the mandatory use of protective equipment in contact with chemicals.

 

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