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Median nail dystrophy - Nail and Distal Digit
Other Resources UpToDate PubMed

Median nail dystrophy - Nail and Distal Digit

Contributors: Bertrand Richert MD, Robert Baran MD
Other Resources UpToDate PubMed

Synopsis

Median nail dystrophy (dystrophia unguium mediana canaliformis or Heller dystrophy) consists of a longitudinal split defect in the middle of the nail plate running from the cuticle to the free edge. Often, short cracks extend laterally in a proximal direction from the split creating a herring-bone or fir-tree appearance. It may be associated with an enlarged lunula. Symmetrical involvement of both thumbnails is most common, though involvement of other fingers and toes has been observed.

The origin of median nail dystrophy is unknown in most patients, though certain cases have been associated with oral isotretinoin therapy. Familial cases have been reported. In approximately 20% of patients, there is known antecedent trauma. Spontaneous regression may be observed, but recurrences are common.

Codes

ICD10CM:
L60.3 – Nail dystrophy

SNOMEDCT:
86393005 – Median nail dystrophy

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Therapy

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References

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Last Updated:07/06/2022
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Median nail dystrophy - Nail and Distal Digit
A medical illustration showing key findings of Median nail dystrophy : Fingernails, Median longitudinal ridge, Scattered nails or distal digits, Solitary nail or digit
Clinical image of Median nail dystrophy - imageId=2789155. Click to open in gallery.  caption: 'A midline longitudinal split, starting at the cuticle and growing toward the free edge of the nail with a few short, chevron-shaped cracks that extend laterally from the split, giving the appearance of an "inverted fir tree." There is also an enlarged lunula.'
A midline longitudinal split, starting at the cuticle and growing toward the free edge of the nail with a few short, chevron-shaped cracks that extend laterally from the split, giving the appearance of an "inverted fir tree." There is also an enlarged lunula.
Copyright © 2024 VisualDx®. All rights reserved.