Median canaliform nail dystrophy treated with a 1064-nm quasi-long pulsed Nd:YAG laser

Abstract

Median canaliform nail dystrophy (MCND) is an uncommon and idiopathic dystrophic change, which typically appears as central, longitudinal groove or split involving one or both thumbnails. Various treatments including a potent topical steroid, an intralesional injection of triamcinolone 2.5–3 mg/dL, medications for systemic treatment, and topical psoralen plus ultraviolet A (PUVA) have been tried to treat the disease. However, each treatment has limitations including severe pain, inconsistent treatment results, long treatment periods, and dissatisfaction with effects of treatment. In recent years, 1064-nm Nd:YAG laser is used for skin rejuvenation by the effect of collagen synthesis and remodeling via induction of growth factor expression. Therefore, we tried 1064-nm Nd:YAG laser to treat this nail dystrophy. A 53-year-old man presented with median nail dystrophy on both thumbs for 3 years. The nail dystrophy was treated only with 1064-nm quasi-long pulsed Nd:YAG laser. He was offered 10 sessions of treatment, and the right thumbnail showed good response and the left thumbnail showed fair response. He experienced severe pain during the treatment (Numerical rating scale (NRS) 8) and was satisfied moderately with the results (NRS 6.5). We report a case of treatment of MCND with 1064-nm quasi-long pulsed Nd:YAG laser with excellent clinical improvement.