Treatment of median canaliform nail dystrophy with topical 0.1% tacrolimus ointment

New Concepts in Median Nail Dystrophy, Onychomycosis, and Hand, Foot, and Mouth Disease Nail Pathology

“…Small cracks or fissures that extend laterally from the central canal or split toward the nail edge give the appearance of an inverted fir tree or Christmas tree. The condition is usually symmetrical and most often affects the thumbs, although other fingers or toes may be involved [4]. …”

“…Presumably, the condition results from a temporary defect in the matrix that interferes with nail formation [4]. Trauma has been implicated as a causative factor [4, 5]. Habitual picking of the nail base may be responsible for some cases [4].…”

“…Trauma has been implicated as a causative factor [4, 5]. Habitual picking of the nail base may be responsible for some cases [4]. Two cases of MND have been reported following the habitual use of personal digital assistants for 4 to 8 months [5].…”

“…Furthermore, the efficacy of such treatments is quite variable. The most recently reported treatment for MND involves topical application of 0.1% tacrolimus ointment once daily without occlusion [4]. Kim et al reported a 19-year-old man with MND affecting both thumbnails [4].…”

“…The most recently reported treatment for MND involves topical application of 0.1% tacrolimus ointment once daily without occlusion [4]. Kim et al reported a 19-year-old man with MND affecting both thumbnails [4]. He was treated with a topical corticosteroid, applied around the proximal nail fold twice a day, with no remarkable changes after 4 weeks.…”