To the Editor.—
In the April 1978 Archives (114:612-613), Drs Scher and colleagues reported a case of 20-nail dystrophy with the histological appearances of lichen planus. We have also seen cases of lichen planus, limited to the nails, which simulated 20-nail dystrophy. In one of our patients, histology also showed the typical histological changes of lichen planus. However, another patient (a young boy) had distinctive histological changes that were more "eczematous" in nature and were certainly not compatible with lichen planus. This case is shortly to be published in the British Journal of Dermatology.At present, therefore, we think that "excess ridging"1 of childhood should be regarded as a physical sign and not a disease entity, unless the results of nail biopsy confirm the diagnosis of lichen planus. In other cases that conform to the original description by Hazelrigg et al,2 and where there is no evidence of
Wilkinson JD, Dawber RPR, Fleming K, Bowers R. Twenty-Nail Dystrophy. Arch Dermatol. 1979;115(3):369. doi:https://doi.org/10.1001/archderm.1979.04010030067029
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: