The condition is characterized by longitudinal ridging (alternating elevation and depression), pitting, loss of luster, and roughening, similar to sandpaper, of the nail surface. Twenty-nail dystrophy is also known as Trachyonychia. It could be said that twenty-nail dystrophy is widespread trachyonchia involving 20 nails.

Trachyonychia is much more common in children, with an insidious onset and peak age of 3 to 12 years, although it can occur at any age. When associated with alopecia, it is more common in males than in females. Trachyonychia was first described by Alkiewicz in 1950 and was dubbed twenty-nail dystrophy of childhood in 1977 by Hazelrigg.


Twenty-nail dystrophy appears to be linked to other skin conditions like lichen planus, eczema, psoriasis, and alopecia areata in some instances, though its exact cause is unknown.

It has been discovered that some inheritance patterns are autosomal dominant.

These conditions tend to be self-limiting and may go away with age. Unknown origin, start gradually in early childhood.


Signs and symptoms include :

Nails turn brittle, rough, and filthy.

The shape of some nails might change.

The longitudinal ridging, pitting, roughening, and splitting in nails are visible.

Nails may become muddy, grayish-white in color, or sandblasted in appearance as they lose their luster.


When it comes to twenty-nail dystrophy, there are many effective medicines available in homoeopathy, but the choice depends on the individuality of the patient, taking into account mental and physical health. Homoeopathy is currently a rapidly growing system that is being practiced all over the world.

ANTIMONIUM CRUDUM 30One of the best treatments for twenty-nail dystrophy, in which the nails grow out of shape, are very brittle, itch when warm in bed, and have horny warts on the hands and soles, is antimonium crudum. Another notable symptom of antimonium crudum is a thickly-coated white tongue.

ALUMINA 30Dry skin that chaps easily, brittle nails, and frequent constipation are all signs of Alumina.

CHRYSAROBINUM 30The best medication for 20-nail dystrophy, which is characterized by ridges and pits in the nails and is linked to psoriasis, is chrysarobinum.

GRAPHITES 30—Graphites is another successful treatment for the condition known as twenty-nail dystrophy, which causes the nails to thicken and become cracked and deformed. The nails are also very brittle and prone to breaking.

FLUORIC ACID 30When nails have longitudinal ridges, are brittle, break easily, grow too quickly and awkwardly, and have lengthwise corrugations, fluoric acid is prescribed.

SILICEA 30Silicea is recommended for people who have twenty-nail dystrophy, which causes the nails to become crippled and deformed. Silicea is also known for its cold feet and palms, as well as its tendency to cause sweaty areas of the body to smell bad, like the feet, hands, and armpits.

When brown spots appear on the hands and arms, the nails become soft, brittle, and ribbed, and the perspiration is strong and sweet-smelling, Thuja occidentalis is prescribed.

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