JAAD OnlineTherapeutic pearlIntralesional triamcinolone matrix injections for treatment of trachyonychia
Section snippets
Therapeutic challenge
Trachyonychia is a nail condition in which patients present with roughness and longitudinal ridging of the nail plates, often likened to sandpaper (opaque), or, less commonly, pearlescent nails with longitudinally arranged pits (shiny). Trachyonychia is more often seen in children, and most cases are idiopathic, but it is also associated with lichen planus, psoriasis, and alopecia areata/universalis.1 Data on trachyonychia treatment in adults are limited to open-label studies, case series, and
Solution
Trachyonychia in adults can be successfully treated with triamcinolone acetonide injections to the nail matrix. After cleansing the proximal nail fold with alcohol and using ethyl chloride as a topical anesthetic, the clinician injects triamcinolone acetonide (2.5 mg/mL in 1% lidocaine, 0.1-0.2 mL) through the proximal nail fold and into the nail matrix with a 30-gauge needle. Injections are administered every 4 to 8 weeks, which is based on the slow growth of fingernails (2-3 mm/month) (Fig 1
References (2)
- et al.
Nail changes in alopecia areata: an update and review
Int J Dermatol
(2018) - et al.
Efficacy and safety of calcipotriol/betamethasone dipropionate ointment for the treatment of trachyonychia: An open-label study
Ann Dermatol
(2015)
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