What Conditions Can Trachyonychia Indicate?

Trachyonychia or 20-nail dystrophy is a condition of the fingernails and toenails that causes interference in the affected individual's nail matrix. All twenty of a patient's nails may be affected, or it may only affect a single nail. Straight, long lines that extend the length of the nail and end at variable heights are characteristic of trachyonychia. Other nail characteristics that occur in 20-nail dystrophy patients include sandpaper-like texture, lack of nail luster, brittle nature, and a rough appearance. While it is most prevalent in childhood ages, this condition can happen to an individual of any age. Most often, trachyonychia appears when an individual is born and progresses over time. Treatment is effective when the underlying cause of a patient's 20-nail dystrophy is successfully treated.

The exact cause of trachyonychia is not clear, but it is strongly associated with numerous other conditions and diseases. Learn about the conditions trachyonychia can indicate now.

Alopecia Areata

Trachyonychia has been strongly linked to individuals affected by a common autoimmune disorder called alopecia areata. The most characteristic symptom that occurs in alopecia areata is an unpredictable loss of hair. This disorder occurs when a patient's immune system inappropriately attacks their hair follicle cells. This malfunction causes the production of hair to lag and results in shrunken hair follicles. The mechanism behind the abnormal immune system attack on such cells is unclear at this time, but it does appear to harbor some genetic factors. Of alopecia areata patients, twenty-five percent have a family member who is also affected. While hair loss is the most classic symptom that appears in this disorder, changes in the fingernails and toenails are also common manifestation. Changes in the nails that include trachyonychia are typically one of the very first indications alopecia areata is developing. Between forty-five and eighty-three percent of all patients affected by trachyonychia are also affected by alopecia areata.

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Atopic Dermatitis

Eczema or atopic dermatitis can cause an affected individual to develop trachyonychia. Atopic dermatitis is a disease that affects the skin and causes the development of dry, scaly patches on a patient's skin. These dry and scaly patches on the skin are often described as extremely itchy and are responsible for intense discomfort that occurs in affected individuals. Atopic dermatitis can happen in a child as early as two or three months old. Approximately ninety percent of atopic dermatitis patients will experience manifestations before they reach half a decade of life. Milder manifestations of atopic dermatitis continue from childhood into adulthood in around half of all patients. Atopic dermatitis happens when the skin's ability to retain moisture becomes impaired. Without the protective moisture barrier function of the skin, external factors or changes can cause inflammatory lesions. Trachyonychia occurrence in eczema is the result of the individual's nail matrix being infiltrated by eczematous change. These changes in the skin around the nail and nail bed cause an interruption of nail synthesis, resulting in trachyonychia and other conditions that affect the nails.

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Lichen Planus

Some individuals affected by lichen planus often also have trachyonychia. Lichen planus is a condition of autoimmune nature that causes irritation and swelling in a patient's mucous membranes, hair, skin, and nails. Bumps appear on the skin of affected individuals, and they are typically purple and flat. These lesions often cause itchiness and may develop into blisters that burst and form crusts. This characteristic skin rash is not infectious, but it can be caused by predisposing genetic factors. Changes in the nails in general that include trachyonychia are seen in around ten percent of lichen planus patients. Nail problems in such individuals are the result of permanent damage or destruction to the nail matrix. This mechanism, along with non-specific nail matrix inflammation causes a disruption in the proper amalgamation of the nails. Between four and 18.5 percent of all individuals affected by trachyonychia are also affected by this inflammatory autoimmune skin disorder.

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Ichthyosis Vulgaris

Trachyonychia can manifest in individuals affected by any one of the numerous genetic skin disorders in the ichthyosis vulgaris family. Disorders within this family cause the protective barrier function of the skin to become impaired, abnormally rapid new skin cell production, and abnormally slow shedding of old skin cells. These malfunctions result in an accumulation of scaly, thick skin in affected individuals. The most common parts of a patient's body affected by these ichthyosis scales are the scalp, face, buttocks, legs, trunk, and stomach. The color of the scales can bet dark brown, white, or gray. This upregulated production of skin cells can cause the part of the nail called the nail fold to experience inflammation on a frequent basis. In addition, the skin cells that reside underneath the nail above the nail bed may experience excessive multiplication and accumulate underneath the nail. Furthermore, the nails of patients affected by any form of ichthyosis tend to grow at a rate two to three times faster than those of a healthy individual. It is a combination of the effects of one or more of these factors that contribute to the association between trachyonychia and ichthyosis vulgaris.

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Psoriasis

Psoriasis patients have also been reported to have nail manifestations that include trachyonychia. Psoriasis is a condition characterized by the acceleration of the life cycle that cells that make up the skin go through. This malfunction results in non-malignant patches and scales on the skin that can be painful. The spots that occur in individuals with psoriasis can range from excessive eruptions of large body regions to small spots with dandruff sized scaling. Psoriasis is a condition characterized by episodic cycles that flare up for weeks to months and then go into remission or subside. It is not uncommon for the fingernails and toenails of psoriasis patients to present with manifestations. The nails can become discolored, grow abnormally, develop pits, become loose, and develop trachyonychia. The mechanism that connects psoriasis to trachyonychia is not clear, but it is known to be associated with the nail bed inflammation caused by skin cell overgrowth. Between approximately thirteen and twenty-six percent of individuals affected by trachyonychia are also affected by psoriasis.