Median nail dystrophy associated with isotretinoin therapy

An abnormal thumbnail

“…Occlusion of the proximal nail fold can help in such cases 2. MND secondary to the use of isotretinoin has also been reported 3. Rare familial cases of MND have been described and we suspect this aetiology in our patient 4…”

Can Median Nail Dystrophy be an Adverse Effect of Alitretinoin Treatment?

“…In the reported cases of isotretinoin-induced median canaliform nail dystrophy, nail changes occurred after 6-8 weeks, and attenuated when treatment was discontinued (3)(4)(5). Alitretinoin, like other licensed retinoids, affects cell formation, cell differentiation, keratinization, apoptosis and immune regulation, and therefore, adverse effects could be expected to be similar to those of isotretinoin (7).…”

“…The pathogenesis of median canaliform nail dystrophy is unknown, but it is believed to be caused by a dyskeratotic reaction in a predisposed individual (4,5). Idiopathic cases are most often self-healing, but when persistent, excision of the nail matrix abnormality can be tried.…”

“…Three case reports of median canaliform nail dystrophy as an adverse effect of acne treatment with isotretinoin (13-cis-retinoic acid) have been published (3)(4)(5). Alitretinoin (9-cis-retinoic acid), on the other hand, is used in the treatment of severe chronic hand eczema (6)(7)(8).…”

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

“…The MND resolved in a few months after personal digital assistant usage was discontinued [5]. It has been shown that some patients on oral isotretinoin may develop MND, with subsequent resolution upon discontinuation of the medication [6, 7]. Rarely, familial occurrences of MND have been reported [8].…”