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To the Editor.—
I read with much interest and some confusion the article "Twenty-Nail Dystrophy of Childhood" by Hazelrigg et al (113:73,1977). The confusion concerned my own 20-nail dystrophy and the observation that the condition is not found in adults. I am a 31-year-old dermatology resident who has had a nail dystrophy since I was in my teens that has extended into the present. All 20 nails are excessively ridged (longitudinally), opalescent, and excessively pitted, and all nails exhibit mild onycholysis (Figure). There are noNails of feet and hands showing 20-nail dystrophy. skin, hair, or mucous membrane abnormalities. Results of KOH preparations and culture of all 20 were negative. There is no history of eczema or paronychia; however, there is a history of maternal psoriasis. Am I the first person with 20-nail dystrophy of adulthood, or do I have just an unusual 20-nail psoriasis without cutaneous involvement or 20-nail
Synkowski DR. Twenty-Nail Dystrophy. Arch Dermatol. 1977;113(10):1462. doi:10.1001/archderm.1977.01640100140044