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. 2021 Mar;48(3):396-402.
doi: 10.1111/cup.13909. Epub 2020 Nov 16.

Histopathologic findings of idiopathic trachyonychia: An analysis of 30 adult patients

Keunyoung Hur  1 , Byeol Han  1 , Sophie Soyeon Lim  2 , Je-Ho Mun  1   3
Affiliations

Histopathologic findings of idiopathic trachyonychia: An analysis of 30 adult patients

Keunyoung Hur et al. J Cutan Pathol. 2021 Mar.

Abstract

Background: Trachyonychia, a rare inflammatory disease of the nail matrix, has a more chronic course in adults compared with that in children. However, the histopathologic features of the disease have not been sufficiently reported in the literature.

Methods: We retrospectively reviewed the pathologic features of idiopathic trachyonychia in adult cases at our center.

Results: A total of 30 cases were included. The median age was 55.5 years (range, 27-77 years). Median disease duration was 84 months (range, 8-384 months). Histopathologic analysis showed upper dermal lymphocytic infiltrates (93.3%), acanthosis (86.7%), exocytosis (63.3%), spongiosis (63.3%), parakeratosis (46.7%), psoriasiform hyperplasia (40%), eosinophilic infiltrates (33.3%), vacuolar degeneration (33.3%), lichenoid pattern (13.3%), Civatte body (6.7%), and collection of neutrophils in the stratum corneum (3.3%). Statistical analysis among pathologic parameters revealed associations of spongiosis with exocytosis (P < 0.001) and lichenoid infiltration with vacuolar degeneration (P = 0.008). Three patients (10%) showed fungal co-infection.

Conclusion: The majority of cases revealed inflammatory cell infiltration with epidermal changes. Given the inflammation and chronic course of idiopathic trachyonychia in adulthood, active treatment with anti-inflammatory agents should be considered. Additionally, mycological tests should be considered during initial evaluation as there are cases with fungal coinfection.

Keywords: histopathology; nail disorder; pathology; trachyonychia; twenty-nail dystrophy.

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References

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