Median canaliform dystrophy of Heller is a rare entity characterized by a midline or a paramedian ridge or split and canal formation in nail plate of one or both the thumb nails. It is an acquired condition resulting from a temporary defect in the matrix that interferes with nail formation. Habitual picking of the nail base may be responsible for some cases. Histopathology classically shows parakeratosis, accumulation of melanin within and between the nail bed keratinocytes. Treatment of median nail dystrophy includes injectable triamcinalone acetonide, topical 0.1% tacrolimus, and tazarotene 0.05%, which is many a times challenging for a dermatologist. Psychiatric opinion should be taken when associated with the depressive, obsessive-compulsive, or impulse-control disorder. We report a case of 19-year-old male diagnosed as median nail dystrophy.

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Pili multigemini and circle hairs (CHs) both are hair shaft deformities. Being asymptomatic and benign they are often under-reported in medical science. Till now, literature showed the involvement of only males. CHs are seen in obese individuals with sedentary lifestyle and pili multigemini is seen in adults over beard and children over scalp. Cosmetic concern in a young female with asymptomatic hyperpigmented papular lesions brought her to dermatology clinic. Apart from histopathology, dermatoscopy is a noninvasive technique that can be utilized for the evaluation of various hair disorders, especially like this.