Twenty-nail dystrophy (trachyonychia) in a child is most commonly associated with which dermatological condition?

• A Psoriasis
• B Alopecia areata ✓
• C Lichen planus
• D Eczema

Explanation

Twenty-nail dystrophy (trachyonychia) — characterised by rough, longitudinally ridged, opaque or sandpaper-like nails affecting all 20 nails — is most commonly associated with alopecia areata in children, though it can occur with lichen planus, psoriasis, and eczema, or be idiopathic. In alopecia areata, the same lymphocytic attack targeting hair follicles can involve the nail matrix. Trachyonychia is usually benign and self-limiting in children. Psoriasis characteristically shows nail pitting, onycholysis, and oil-drop sign, while lichen planus can cause pterygium formation and permanent nail loss.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.