Median canaliform dystrophy of Heller after cryotherapy

Abstract

Cryotherapy, widely used in the treatment of common warts, can cause long-term side effects when used in the treatment of warts near the nail bed. Here we present the case of a 11-year-old girl who developed canaliform dystrophy and long-term hypopigmentation following cryotherapy of warts on the proximal nail folds.

Median canaliform dystrophy of Heller

“…However, the case was lost to follow up after putting the patient first review [1]. Damevska et al reported 11 year old girl who developed canaliform dystrophy and long-term hypopigmentation following cryotheraphy of warts on proximal nail folds [6]. In our patient described herein, this case is special because self-inflicting nail trauma involving manipulation of cuticular portion of proximal nail fold and familial were not present.…”

Median canaliform nail dystrophy in a 2‐year‐old boy: Case report and review of the literature

“…It is postulated that MCD is induced by trauma, medication, or unknown etiology. Reported modes of trauma include nail biting, 8 from scratching caused by pruritus associated with atopic dermatitis, 9 self‐induced with stress or anxiety, 10–12 and cryotherapy 7 . Medications that have been reported to induce median canaliform dystrophy include isotretinoin, 13–17 aliretinoin, 18 and HIV treatment ritonavir 2 .…”

“…Reported modes of trauma include nail biting, 8 from scratching caused by pruritus associated with atopic dermatitis, 9 self-induced with stress or anxiety, [10][11][12] and cryotherapy. 7 Medications that have been reported to induce median canaliform dystrophy include isotretinoin, [13][14][15][16][17] aliretinoin, 18 and HIV treatment ritonavir. 2 In addition to unknown causes, 19 there has also been a suggested familial etiology.…”

“…Her symptoms developed 2 months post cryotherapy for her periungual warts and resolved 8 months later with no treatment and no further cryotherapy. 7 It is postulated that MCD is induced by trauma, medication, or unknown etiology. Reported modes of trauma include nail biting, 8 from scratching caused by pruritus associated with atopic dermatitis, 9 self-induced with stress or anxiety, [10][11][12] and cryotherapy.…”

Successful treatment of median canaliform nail dystrophy with topical tazarotene foam

“…1 It may also be caused by trauma to the nail plate or nail bed, subungual tumors, or medications such as oral retinoids. 1 , 2 , 3 Treatment of MCND is challenging, as there are no therapies demonstrating consistent efficacy. Here, we present a case of MCND that dramatically improved with daily application of topical tazarotene 0.1% foam.…”