Nail Longitudinal Striation

Aka: Nail Longitudinal Striation, Nail Longitudinal Band, Trachyonychia, 20-nail Dystrophy, Twenty Nail Dystrophy

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II. Definitions

  1. Trachyonychia
    1. Striations due to aging
    2. Associated with sandpaper appearance to nail
  2. 20-nail Dystrophy
    1. Diffuse Trachyonychia involving all nails

III. Causes: Diffuse Trachyonychia (20-nail Dystrophy)

  1. Alopecia Areata
  2. Vitiligo
  3. Psoriasis
  4. Atopic Dermatitis

IV. Types: Longitudinal Lines

  1. Nail Splinter Hemorrhage
    1. Subacute Bacterial Endocarditis
    2. May also be caused by Oral Contraceptives, Psoriasis, cancer, Rheumatologic Disorders, Trauma
  2. Median Nail Groove causes
    1. Habit tics
    2. Self-limiting dystrophy of Heller
  3. Dark pigmented longitudinal lines (Melanonychia)
    1. Vertical Nail Bands (Longitudinal Melanonychia)
      1. Normal variant in patients with dark-skin
    2. Subungual Melanoma (also seen with dark-skin)
      1. See Melanonychia

V. References

  1. Fawcett (2004) Am Fam Physician 69(6):1417-24 [PubMed]

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