Treatment of Washboard Nail with Topical Tacrolimus Ointment / 대한피부과학회지

Washboard nail is a dystrophy that presents as a series of ridges that extends across the nail. It is often accompanied by a central depression that extends from the cuticle to the free edge. Washboard nail is often a result of frequently repeated trauma, but sometimes predisposing factors cannot be found. When habitual tic is the cause of the lesions, restraining the habit is the most important treatment. Here, we report a case of a 6-year-old male with washboard nails on both thumbnails and was treated with topical 0.1% tacrolimus ointment. Significant improvement was observed after 4 months of application. This case suggests that topical tacrolimus can be considered as a primary therapy in the treatment of washboard nails in the absence of trauma.

Comments to "Various Nail Disorders Misdiagnosed and Treated as Onychomycosis" / 대한피부과학회지

No abstract available.

A Clinical Study of 21 Cases of Washboard Nail / 대한피부과학회지

BACKGROUND: Washboard nail most commonly involves the thumbnail or great toenail. As its name implies, it resembles a washboard with a series of evenly spaced ridges across the nail. A central depression can be seen as well. This can develop as the result of repeated habitual trauma to the proximal nail fold by the other fingers or by biting the nailplate. Thus, it is also called habit tic deformity or traumatic nail dystrophy. Although it is known to be not uncommon, there have been no studies on this with a sufficient number of cases and long term follow up. OBJECTIVE: This study was conducted to provide a better understanding of washboard nail and to estimate the outcome of it. METHODS: We reviewed all the medical records and clinical photographs of 21 patients who had been diagnosed with washboard nail at our department between July 2000 and July 2009. RESULTS: The male to female ratio was 1:1.3. The patients' ages varied from 6 to 68 years, with an average of 25.4 years. The mean duration at the first visit was 4.4 years. The most common involved site was both thumbnails. Predisposing factors were found in 42.9% of the patients, which included nail picking or onychophagia. The treatment options were primarily intralesional triamcinolone injection and topical steroid. If the patient had the habitual tic, we educated them to restrain it. The follow up periods varied from 1 to 32 months with a mean of 7.9 months. Among the 14 patients with adequate follow up, 50% of these patients showed clinical improvement. CONCLUSION: This study demonstrated the clinical features of washboard nail. Physicians should closely observe the nail changes and long-term follow up is needed to determine the therapeutic response of patients with washboard nail.