Spongiotic Trachyonychia Treated with Topical Corticosteroids Using the Paper Tape Occlusion Method.

To the Editor, Trachyonychia, also known as 20-nail dystrophy or rough nails, is characterized by surface roughness and opacity of the nail due to extensive longitudinal ridging [1–3] . The condition may be idiopathic or associated with eczema, lichen planus, psoriasis, or alopecia areata [1–3] . Although spontaneous resolution can be expected in trachyonychia, aggressive treatments are necessary in severe cases [1–3] . Here, we report a case of spongiotic trachyonychia successfully treated with topical corticosteroids using the paper tape occlusion method. A 45-year-old man presented with dystrophic changes of all fingernails and toenails that had started 2 years earlier. He was otherwise healthy and had no medical history of significant skin diseases, including psoriasis, lichen planus, or alopecia areata. Careful examination revealed surface roughness, extensive ridging, and opaque thickening of the nails ( fig. 1 ). Moreover, the proximal nail folds, where he had been complaining of severe