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Pediatric trachyonychia, also known as 20-nail dystrophy, is an idiopathic acquired nail disease characterized by ridging, pitting, and roughening of the nails. Pathology is variable. Some patients develop other dermatoses, while others have spontaneous resolution. Investigators at a pediatric tertiary care practice identified 11 children with trachyonychia over a 12-year period and followed them with physician evaluation, photographs, and questionnaires. Patients with other dermatoses at the initial visit were excluded.
In six girls and five boys, nail changes occurred at a mean age of 2.7 years (range 2–7 years). Average follow-up was 66 months (range, 10–126 months). No patients had family history of trachyonychia; one had a family histor…